Individual provider · Type 1 NPI

Richard Lee Tillman

General Practice Dentistry · Portland, OR

NPI number 1417957010 Active

Practice location

833 SW 11th Ave, Suite 600
Portland, OR 97205-2125

Call (503) 223-9725 Map

Mailing address

6500 SE Scott Dr
Portland, OR 97215-2018

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry Primary 1223G0001X4466 (OR)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

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About NPI 1417957010

Richard Lee Tillman's National Provider Identifier is 1417957010, issued on Jul 26, 2005. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Portland, OR. The record was last updated on Jul 13, 2026.