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

Peterson Periodontics & Implantology LLC

Organization Periodontics · NPI 1801310008

Peterson Periodontics & Implantology LLC is a Periodontics in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2017.

Licensed in
OR
In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5528 SE Powell Blvd
Portland, OR 97206-2956
Phone: (503) 788-1008
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X · Licence D9905 (OR)

Record details

NPI number1801310008
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Andrew Peterson — Periodontist, Member Of Llc · (406) 861-8844
NPI enumeratedJuly 29, 2017
Last updated in NPPESJuly 29, 2017
Mailing address4420 Se 51st Ave, Portland, OR 97206-3910

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