NPI 1205664844

Summit Oregon LLC

Organisation Oral & Maxillofacial Surgery (D.M.D.) Portland, OR

Practice location

Address: 3332 N Lombard St STE C, Portland, OR 97217-1258
Phone: (503) 548-2006
Fax: (503) 548-2012

Authorised official

Name: Prashant Charugundla
Title: Oral & Maxillofacial Surgeon
Phone: (503) 548-2006

Registered specialties

Oral & Maxillofacial Surgery (D.M.D.) Primary

Allopathic & Osteopathic Physicians Taxonomy 204E00000X

Other Oral & Maxillofacial Surgery providers in Oregon →

Registry record

NPI: 1205664844
Entity type: Organization
NPI issued: 24 Jul 2024
Record last updated: 6 Apr 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.