Basic Information
Provider Information
NPI: 1295805885
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TAINTER
FirstName: WILLIAM
MiddleName: F
NamePrefix: DR.
NameSuffix:  
Credential: D.M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6950 NE CAMPUS WAY
Address2:  
City: HILLSBORO
State: OR
PostalCode: 971245611
CountryCode: US
TelephoneNumber: 5039522125
FaxNumber: 5035264418
Practice Location
Address1: 4925 SW GRIFFITH DR
Address2:  
City: BEAVERTON
State: OR
PostalCode: 970052923
CountryCode: US
TelephoneNumber: 5032772014
FaxNumber: 5032772263
Other Information
ProviderEnumerationDate: 11/09/2006
LastUpdateDate: 04/30/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1223G0001XD5222ORY Dental ProvidersDentistGeneral Practice

No ID Information.


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