Healthcare Provider Details

I. General information

NPI: 1841156775
Provider Name (Legal Business Name): MATTHEW W. VOGEL, DMD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 SE 223RD AVE STE 140
GRESHAM OR
97030-2576
US

IV. Provider business mailing address

1201 SE 223RD AVE STE 140
GRESHAM OR
97030-2576
US

V. Phone/Fax

Practice location:
  • Phone: 503-665-8116
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: CHRISTY DUPIN
Title or Position: MANAGER OF CREDENTIALING
Credential:
Phone: 480-674-4151