Willamette Dental

Willamette Dental is a healthcare organization registered as Health Maintenance Organization in Beaverton, OR, holding Type 2 (organization) NPI 1194143065 since 2014. The authorized official on file is Manimone Phanthamath, Dental Hygienist.

✓ Active NPI ✓ Valid NPI checksum

NPI	1194143065
Entity type	Organization (Type 2)
Legal business name	Willamette Dental
Practice address	4925 SW GRIFFITH DR, Beaverton, OR, 97005
Phone	8554336825
Enumeration date	2014-03-28
Last updated in NPPES	2014-03-28

Authorized official

Name	Manimone Phanthamath
Title	Dental Hygienist
Phone	5037157876

Taxonomy & classification

Taxonomy code	Specialty	Primary	License	State
302R00000X	Health Maintenance Organization	Primary	H5456	OR

Copy-ready billing details

Provider: Willamette Dental
NPI: 1194143065
Taxonomy: 302R00000X (Health Maintenance Organization)
Address: 4925 SW GRIFFITH DR, Beaverton, OR, 97005

Providers at this address

NPI	Name	Type	Specialty	Location
1447361381	Gary Dixon	Individual	General Practice Dentistry	Beaverton, OR
1295805885	William Tainter	Individual	General Practice Dentistry	Beaverton, OR
1457421083	Phuong Luu	Individual	General Practice Dentistry	Beaverton, OR
1598830911	Mimi Whittemore	Individual	General Practice Dentistry	Beaverton, OR
1831253335	Mark Vandusen	Individual	Orthodontics and Dentofacial Orthopedics Dentistry	Beaverton, OR
1376888297	Ruben Alcazar	Individual	Orthodontics and Dentofacial Orthopedics Dentistry	Beaverton, OR
1568890275	Sara Nathman	Individual	Dental Hygienist	Beaverton, OR
1710317482	Willettedental	Organization	Preferred Provider Organization	Beaverton, OR

Verify this record

Cross-check NPI 1194143065 against the authoritative CMS record: view Willamette Dental on the official NPPES registry .

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.

Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2014-03-28. Verify at npiregistry.cms.hhs.gov.

Where is Willamette Dental located?

The practice location on file with NPPES is in Beaverton, OR.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2014-03-28.