Octavia S. Lively, DDS

Dentist · Portland, OR

Individual Active NPI

NPI number 1003256827

Practice location

3710 SW Us Vetrn Hosp Rd
Portland, OR 97239-2964
Phone
(503) 220-8262

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NPI record

NPI
1003256827
Entity type
Individual (Type 1)
Enumeration date
June 25, 2013
Last updated
February 12, 2019
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X D10027 OR

About Dr. Lively

Octavia S. Lively, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 3710 SW Us Vetrn Hosp Rd, Portland, OR 97239-2964. The NPI number 1003256827 was assigned on June 25, 2013 and the record was last updated on February 12, 2019.

Dr. Lively lists a license in the registry: #D10027 (OR) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Octavia S. Lively, DDS?

The NPI number is 1003256827.

What is the phone number of Dr. Lively?

The phone number listed for the practice location is (503) 220-8262.

Where is Dr. Lively located?

3710 SW Us Vetrn Hosp Rd, Portland, OR 97239-2964.

What is the taxonomy code for Dr. Lively?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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