Healthcare Provider Details

I. General information

NPI: 1801312145
Provider Name (Legal Business Name): MARK HOUSTON DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2017
Last Update Date: 07/05/2025
Certification Date: 07/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7275 SW DARTMOUTH ST STE 180
TIGARD OR
97223-8292
US

IV. Provider business mailing address

10800 SE 5TH ST UNIT E17
VANCOUVER WA
98664-4633
US

V. Phone/Fax

Practice location:
  • Phone: 503-620-2319
  • Fax:
Mailing address:
  • Phone: 44-793-9509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberD12142
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: