NPIMap

Organization Active NPI

Elm Street Dental LLC

  • General Practice Dentistry
  • Albany, OR
National Provider Identifier
1003295015
Registry record updated May 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D7193 Issued in OR
Legal business name
ELM STREET DENTAL LLC
Practice address
1036 Elm St SW
Albany, OR 97321-2039
Phone
(541) 928-2993
Fax
(541) 926-0339
NPI assigned
May 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Lane S Harris, DMD
Title
Member
Phone
(541) 928-2993

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X D7193 OR Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X D9733 OR

Addresses

Primary practice location

1036 Elm St SW
Albany, OR 97321-2039

Mailing address

1036 Elm St SW
Albany, OR 97321-2039
Phone (541) 928-2993

Other names 1

  • Elm Street Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

1036 Elm St SW
Albany, OR 97321
Phone (541) 926-7330

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1432252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432252800000",
    "number": "1003295015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1036 ELM ST SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973212039",
            "telephone_number": "541-928-2993",
            "fax_number": "541-926-0339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 ELM ST SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973212039",
            "telephone_number": "541-928-2993",
            "fax_number": "541-926-0339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELM STREET DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-22",
        "last_updated": "2015-05-22",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "LANE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "541-928-2993",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7193",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9733",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elm Street Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albany, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.