# NOPO KIDS DENTISTRY, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760869143
- **Authorized official:** WENDI L TJOSTOLVSON (PATIENT FINANCIAL COORDINATOR)
- **Authorized official phone:** (971) 978-0009

## Contact information

- **Practice address:** 4548 N ALBINA AVE, PORTLAND, OR 97217-3010
- **Practice address phone:** (503) 626-9700
- **Practice address fax:** (503) 626-9772
- **Mailing address:** 4548 N ALBINA AVE, PORTLAND, OR 97217-3010
- **Mailing address phone:** (971) 978-0009
- **Mailing address fax:** (971) 978-0020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | OR | Yes |

## Other

- **Enumeration date:** 05/05/2015
- **Last updated:** 01/17/2019