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

Daniel Petrisor, DMD, MD

Individual provider Oral & Maxillofacial Surgery (D.M.D.) · NPI 1235332834

Daniel Petrisor, DMD, MD is a Maxillofacial Surgery in Portland, Oregon. Practices with University Professional Services, a 1,704-clinician group and accepts Medicare assignment. Licensed in Oregon.

Licensed in
OR
In the registry since
2007
Specialties on file
2
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone: (503) 494-8916
Fax: (503) 494-6783
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral & Maxillofacial Surgery (D.M.D.) (primary) Taxonomy 204E00000X · Licence MD154906 (OR)
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X · Licence D9059 (OR)

Record details

NPI number1235332834
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD , MD
Sole proprietorNo
NPI enumeratedJune 9, 2007
Last updated in NPPESJuly 16, 2025
Certification dateJuly 16, 2025
Mailing address3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMAXILLOFACIAL SURGERY
Also practisesORAL SURGERY
Medical schoolOTHER
Group practice University Professional Services — 1704 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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