Robert Lyle McCullough, DMD

General Practice Dentistry · Tigard, OR

Individual Active NPI

NPI number 1164926788

Practice location

11820 SW King James Pl Ste 20
Tigard, OR 97224-2481
Phone
(503) 968-2901
Fax
(503) 406-4988

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NPI record

NPI
1164926788
Entity type
Individual (Type 1)
Enumeration date
March 20, 2018
Last updated
September 10, 2019
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X D11114 OR

Mailing address

27440 SW Vanderschuere Rd
Hillsboro, OR 97123-9439
Phone
(503) 964-8909

About Dr. McCullough

Robert Lyle McCullough, DMD is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 11820 SW King James Pl Ste 20, Tigard, OR 97224-2481. The NPI number 1164926788 was assigned on March 20, 2018 and the record was last updated on September 10, 2019.

Dr. McCullough lists a license in the registry: #D11114 (OR) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Robert Lyle McCullough, DMD?

The NPI number is 1164926788.

What is the phone number of Dr. McCullough?

The phone number listed for the practice location is (503) 968-2901.

Where is Dr. McCullough located?

11820 SW King James Pl Ste 20, Tigard, OR 97224-2481.

What is the taxonomy code for Dr. McCullough?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

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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