Provider Demographics
NPI:1851481238
Name:NEWPORT, NAVID O (DDS)
Entity Type:Individual
Prefix:
First Name:NAVID
Middle Name:O
Last Name:NEWPORT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7425 WRIGLEY DR
Mailing Address - Street 2:#201
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-5292
Mailing Address - Country:US
Mailing Address - Phone:509-543-4948
Mailing Address - Fax:
Practice Address - Street 1:2502 PORTLAND RD
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-1923
Practice Address - Country:US
Practice Address - Phone:503-538-4289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1258122300000X
ORD95241223P0221X
WADE00010688122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKDD4177Medicaid
1959872OtherUNITED CONCORDIA
OR500636537Medicaid
WA5058136Medicaid