Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mountainside General Dentistry

Organization Dentist · NPI 1215104476

Mountainside General Dentistry is a Dentist in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2008.

Licensed in
OR
In the registry since
2008
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

3740 SE 122nd Ave
Portland, OR 97236-3405
Phone: (503) 762-2525
Fax: (503) 762-4872
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence D7895 (OR)

Record details

NPI number1215104476
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lenore Supnet — Dentist · (503) 762-2525
NPI enumeratedMay 15, 2008
Last updated in NPPESMay 15, 2008
Mailing address3740 Se 122nd Ave, Portland, OR 97236-3405

Other providers in Portland