Tesha Waggoner DMD PC

Public-record details

Address

5415 Sw Westgate Dr., Suite 207, Portland, OR 97221

Phone

(503) 292-9274

Listed under

Practices and organizations

NPI

1790558997

NPI status

Active in the NPPES registry

Provider type

Organization (practice, clinic or company)

Registered specialty (self-reported taxonomy)

Pediatric Dentistry (1223P0221X)

Authorized official

Tesha Waggoner, DMD, Owner

NPI first issued

Oct 31, 2023

Years since NPI first issued

3 years (since 2023)

NPI record last updated

Oct 31, 2023

Pediatric dentistry listings at this street address

2 (this one included)

Individual pediatric dentists listed at this address

1

NPI 1790558997 is active in the federal NPPES registry (CMS) with Pediatric Dentistry, an ADA-recognized dental specialty, as its self-reported primary taxonomy. Source: NPPES NPI Registry (CMS) (record). Data as of 2026-10-16.

Public record, not an endorsement. This listing was compiled from public records as of 2026-10-16 and may be incomplete or out of date. Pediatric Dentist Index does not vet, employ, recommend or guarantee pediatric dental practices; a badge reflects only what the public record showed on that date. Confirm current details with the official record before you decide. The information on Pediatric Dentist Index is not medical advice and does not replace a doctor, nurse, discharge planner or other qualified professional. Do not use it to make decisions about diagnosis or treatment. If you have a medical emergency, call 911. Full disclaimer · Report an error

What these registry facts mean

The NPI (National Provider Identifier) is the federal ID every HIPAA-covered provider uses to bill insurance. This NPI belongs to an organization, so it may cover several clinicians at this location. The specialty is the taxonomy the provider chose when registering; NPPES does not check it. A license number here is what the provider entered — confirm it with the state board before you rely on it. Pediatric dentists are dentists who completed an accredited pediatric dentistry residency after dental school. A registered specialty is not board certification. Verify the dental license with the state dental board and board certification with the American Board of Pediatric Dentistry.

View NPI 1790558997 in the official registry ↗

Pediatric dentists at this address

Other listings in this directory whose NPI record gives the same street address and ZIP. A shared address usually means a shared practice or building; it does not by itself show who works with whom.

• Richard Park, DMD