MEDICARE: WESTSIDE PERIODONTICS & IMPLANTOLOGY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center	D8855	OR

General Provider Information

NPI Number	:	1124390281
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTSIDE PERIODONTICS & IMPLANTOLOGY LLC

Provider Business Mailing Address
First Line	:	9934 NW SKYLINE HEIGHTS DR
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97229-2634
Country	:	US
Telephone Number	:	503-799-5383
Fax Number	:

Provider Business Practice Location Address
First Line	:	9934 NW SKYLINE HEIGHTS DR
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97229-2634
Country	:	US
Telephone Number	:	503-799-5383
Fax Number	:

Authorized Official
Title or Position	:	PERIODONTIST
Name	:	DR. VAHID THOMAS ESHRAGHI
Credential	:	DMD
Telephone Number	:	503-799-5383

Provider Enumeration Date	:	02/06/2012
Last Update Date	:	02/06/2012

Similar Medicare Providers

1548367683 — ADAM C WATKINS
Practice Location Address:

521 SW 11TH AVE , SUITE 200
PORTLAND, OR
97205-2634

Practice Phone: 503-944-1226
Practice Fax:

1922173947 — TINA HADLEY LMFT
Practice Location Address:

521 SW 11TH AVE , 2ND FLOOR
PORTLAND, OR
97205-2634

Practice Phone: 503-944-1226
Practice Fax: 503-224-6047

1912053331 — CASCADIA BEHAVIORAL HEALTH
Practice Location Address:

521 SW 11TH AVE
PORTLAND, OR
97205-2634

Practice Phone: 503-969-9071
Practice Fax:

1578619821 — ELZBIETA HOWARD
Practice Location Address:

521 SW 11TH AVE
PORTLAND, OR
97205-2634

Practice Phone: 503-944-1219
Practice Fax:

1790831147 — DEBORAH LOUISE ALLISON QMHA
Practice Location Address:

521 SW 11TH AVE
PORTLAND, OR
97205-2634

Practice Phone: 503-944-1205
Practice Fax:

1316083439 — BARBARA SNOW LCSW
Practice Location Address:

521 SW 11TH AVE
PORTLAND, OR
97205-2634

Practice Phone: 503-944-1201
Practice Fax: 503-224-6047

Directions to “WESTSIDE PERIODONTICS & IMPLANTOLOGY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.