Dr. Stan Edwin Edwards, d.d.s.
Dentist, General Practice in Portland, OR. Individual provider (NPI-1).
NPI number1477546570
StatusActive
Last updated in NPPESOct 29, 2007
Details
- NPI
- 1477546570
- Entity type
- Individual (NPI-1)
- Name
- Dr. Stan Edwin Edwards
- Credential
- d.d.s.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 24, 2005
- Last updated
- Oct 29, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · ORDER AND REFERRING ONLY - ORAL SURGERY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | D8733 | OR | Yes |
| 1223G0001X | Dentist, General Practice | DE00009370 | WA | |
| 1223G0001X | Dentist, General Practice | DD2753 | NM |
Practice location
1585 Sw Marlow Ave Ste 220Portland, OR 97225-5178
Phone 503-297-7231 · Fax 503-291-1335
Mailing address
1585 Sw Marlow Ave Ste 220Portland, OR 97225-5178
Phone 503-297-7231 · Fax 503-291-1335
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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