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

Dr. Gideon Prasanth Kodali, DMD

Individual provider Dentist · NPI 1194403485

Dr. Gideon Prasanth Kodali, DMD is a Dentist in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2023.

Licensed in
OR
In the registry since
2023
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

15715 NW Central Dr Ste 7
Portland, OR 97229-1267
Phone: (503) 610-4038
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence D11813 (OR)

Record details

NPI number1194403485
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorNo
NPI enumeratedJuly 7, 2023
Last updated in NPPESJuly 7, 2023
Certification dateJuly 7, 2023
Mailing address6334 Se Imagine Way, Hillsboro, OR 97123-5059

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