Healthcare Provider Details

I. General information

NPI: 1760475529
Provider Name (Legal Business Name): HOWARD M FREEDMAN DDS,PC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 S MOODY AVE
PORTLAND OR
97201-5042
US

IV. Provider business mailing address

2730 S MOODY AVE ATTN: PATIENT FINANCIAL SERVICES
PORTLAND OR
97201-5042
US

V. Phone/Fax

Practice location:
  • Phone: 503-494-8921
  • Fax:
Mailing address:
  • Phone: 503-494-8921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberD6944
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: