Organization · Type 2 NPI
Waggoner Dentistry PC
Pediatric Dentistry · Lake Oswego, OR
NPI number
1093646085
Active
Practice location
15962 Boones Ferry Rd Ste 208
Lake Oswego, OR 97035-4360
Mailing address
5415 SW Westgate Dr Ste 207
Portland, OR 97221-2429
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Dentistry Primary | 1223P0221X | None listed |
Pediatric Dentistry: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Another provider at this address
About NPI 1093646085
Waggoner Dentistry PC's National Provider Identifier is 1093646085, issued on May 27, 2026. The primary taxonomy on file is Pediatric Dentistry (1223P0221X), and the practice location is in Lake Oswego, OR. The record was last updated on May 27, 2026.