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

Three Rivers Oral and Facial Surgery LLC

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1164265633

Three Rivers Oral and Facial Surgery LLC is an Oral and Maxillofacial Surgery (Dentist) in Tualatin, Oregon. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

6464 SW Borland Rd Ste D3
Tualatin, OR 97062-8861
Phone: (503) 692-5654
Show map & directions

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

Specialties & licences

Oral & Maxillofacial Surgery (D.M.D.) (primary) Taxonomy 204E00000X
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X

Record details

NPI number1164265633
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Daniel Petrisor — Surgeon · (503) 692-5654
NPI enumeratedJune 13, 2024
Last updated in NPPESJune 13, 2024
Certification dateJune 13, 2024
Mailing address6464 Sw Borland Rd Ste D3, Tualatin, OR 97062-8861

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