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EASTERN OREGON DENTAL CLINIC LLC NPI 1609043157


NPI Information

NPI: 1609043157
Provider Name: EASTERN OREGON DENTAL CLINIC LLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
475 SW 12TH ST
ONTARIO, OR
ZIP 97914
Phone: (541) 881-1794
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EASTERN OREGON DENTAL CLINIC LLC is a general practice dentist in Ontario, OR. The provider is 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. EASTERN OREGON DENTAL CLINIC LLC NPI is 1609043157. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

475 SW 12TH ST
ONTARIO, OR
ZIP 97914-201
Phone: (541) 881-1794
Fax: (541) 889-2904

The provider's authorized official is Eric N Dahle .
The authorized official title is Member and has the following contact phone number (541) 881-1794.

The enumeration date for this NPI number is 5/14/2008 and was last updated on 5/14/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1122300000XDentistD9048OREGONNo
2122300000XDentistD6574OREGONNo
3122300000XDentistD7219OREGONNo
41223E0200XDentistEndodonticsD9048OREGONNo
51223E0200XDentistEndodonticsD6574OREGONNo
61223E0200XDentistEndodonticsD7219OREGONNo
71223G0001XDentistGeneral PracticeD9048OREGONNo
81223G0001XDentistGeneral PracticeD7219OREGONNo
91223P0300XDentistPeriodonticsD6574OREGONNo
101223P0300XDentistPeriodonticsD9048OREGONNo
111223P0300XDentistPeriodonticsD7219OREGONNo
121223S0112XDentistOral and Maxillofacial SurgeryD9048OREGONNo
131223S0112XDentistOral and Maxillofacial SurgeryD6574OREGONNo
141223S0112XDentistOral and Maxillofacial SurgeryD7219OREGONNo
151223G0001XDentistGeneral PracticeD6574OREGONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.