Derek W. Conklin Dmd PC
Derek W. Conklin Dmd PC is a healthcare organization registered as Dentist in Sandy, OR, holding Type 2 (organization) NPI 1558635391 since 2012. The authorized official on file is Derek Conklin, President.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1558635391 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Derek W. Conklin Dmd PC |
| Practice address | 17471 SHELLEY AVE STE A, Sandy, OR, 97055 |
| Phone | 5036684655 |
| Fax | 5036688755 |
| Enumeration date | 2012-02-24 |
| Last updated in NPPES | 2012-02-24 |
Authorized official
| Name | Derek Conklin |
|---|---|
| Title | President |
| Phone | 5036684655 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 122300000X | Dentist | Primary | D8325 | OR |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 243185 | Medicaid | OR | — |
Copy-ready billing details
Provider: Derek W. Conklin Dmd PC NPI: 1558635391 Taxonomy: 122300000X (Dentist) Address: 17471 SHELLEY AVE STE A, Sandy, OR, 97055
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1396868048 | Derek Conklin | Individual | Dentist | Sandy, OR |
Verify this record
Cross-check NPI 1558635391 against the authoritative CMS record: view Derek W. Conklin Dmd PC 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
What type of organization is Derek W. Conklin Dmd PC?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2012-02-24.