Healthcare Provider Details

I. General information

NPI: 1295683563
Provider Name (Legal Business Name): CURTIS B. BEDONT, DMD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1042 NW NORMAN AVE STE 210
GRESHAM OR
97030-5554
US

IV. Provider business mailing address

1042 NW NORMAN AVE STE 210
GRESHAM OR
97030-5554
US

V. Phone/Fax

Practice location:
  • Phone: 503-665-1115
  • Fax:
Mailing address:
  • Phone: 503-665-1115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: CURTIS BEDONT
Title or Position: ORTHODONTIST/OWNER
Credential: DMD
Phone: 503-515-1816