CLIFFORD DANIEL HEABERLIN NPI 1700313871

NPI Information

NPI: 1700313871
Provider Name: CLIFFORD DANIEL HEABERLIN
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

PECOS Registration: Yes

Address:
9775 SE SUNNYSIDE RD STE 200
CLACKAMAS, OR
ZIP 97015
Phone: (503) 655-8471
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Clifford Daniel Heaberlin is a general practice dentist in Clackamas, OR. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. Clifford Daniel Heaberlin NPI is 1700313871. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

9775 SE SUNNYSIDE RD STE 200
CLACKAMAS, OR
ZIP 97015-721
Phone: (503) 655-8471

The NPI 1700313871 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 5/18/2017 and was last updated on 7/27/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	D10706	OREGON	Yes
2	390200000X	Student in an Organized Health Care Education/Training Program				No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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