Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brilliant Smile Dental, PC

Organization Dentist · NPI 1215209861

Brilliant Smile Dental, PC provides Dentist services in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2012.

Licensed in
OR
In the registry since
2012
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12720 SE Stark St
Portland, OR 97233-1539 Not confirmed with CMS for 12 years — call before visiting
Phone: (503) 252-6133
Fax: (503) 257-6886
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence D7803 (OR)

Record details

NPI number1215209861
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Nicole Luong — President · (503) 708-8059
NPI enumeratedJanuary 28, 2012
Last updated in NPPESJanuary 31, 2014
Mailing address12720 Se Stark St, Portland, OR 97233-1539

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