Provider Demographics
NPI:1295526002
Name:MAI DENTAL, LLC
Entity type:Organization
Organization Name:MAI DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST (OWNER)
Authorized Official - Prefix:DR
Authorized Official - First Name:CHLOE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:714-204-8508
Mailing Address - Street 1:19099 MEGAN PL
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-7468
Mailing Address - Country:US
Mailing Address - Phone:714-204-8508
Mailing Address - Fax:
Practice Address - Street 1:9975 SW NIMBUS AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-7150
Practice Address - Country:US
Practice Address - Phone:714-204-8508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty