Dr. Peter John Lax
Pediatric Dentist
830 Ne 47th Ave
Portland
, Oregon 97213-2212
Dr. Peter John Lax
Pediatric Dentist
830 Ne 47th Ave
Portland
, Oregon 97213-2212
(503) 235-3255
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About
Features
Specialties
- Pediatric Dentist
Languages spoken
- English
Location
First Address
- Dr. Peter John Lax
- 720 Ne Laurelhurst Pl
- Portland, OR
- Zip : 97232-2653
- Phone : (503) 235-3255
Second Address
- Dr. Peter John Lax
- 830 Ne 47th Ave
- Portland, OR
- Zip : 97213-2212
- Phone : (503) 215-2400
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0221X | Pediatric Dentist | D5068 | OR |
National Provider Identifier
| NPI | 1053408005 |
|---|---|
| Provider Name | Dr. Peter John Lax |
| First Address | Portland, OR 97232-2653 |
| Second Address | Portland, OR 97213-2212 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/10/2006 |
| Last Update Date | 04/07/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 111583 | (05) | OR |
| T67837 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.