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

Waggoner Dentistry PC

Organization Pediatric Dentistry · NPI 1093646085

Waggoner Dentistry PC is a Pediatric Dentistry in Lake Oswego, Oregon. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

15962 Boones Ferry Rd Ste 208
Lake Oswego, OR 97035-4360
Phone: (503) 292-9274
Show map & directions

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

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X

Record details

NPI number1093646085
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tesha Waggoner — Owner · (503) 292-9274
NPI enumeratedMay 27, 2026
Last updated in NPPESMay 27, 2026
Certification dateMay 27, 2026
Mailing address5415 Sw Westgate Dr Ste 207, Portland, OR 97221-2429

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