NPIMap

Organization Active NPI

Santiam Dental Group, LLC

  • General Practice Dentistry
  • Lebanon, OR
National Provider Identifier
1003898073
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D5083 Issued in OR
Legal business name
SANTIAM DENTAL GROUP, LLC
Practice address
150 Market St
Lebanon, OR 97355-2334
Phone
(541) 451-4300
Fax
(541) 451-4799
NPI assigned
Nov 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2018

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

Authorized official

Name
Mr. Kevin E. Osborne, DMDNPI 1295922250
Title
Dentist
Phone
(541) 451-4300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X D7346 OR
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X D5083 OR Primary

Addresses

Primary practice location

150 Market St
Lebanon, OR 97355-2334

Mailing address

150 Market St
Lebanon, OR 97355-2334
Phone (541) 451-4300

Other names 1

  • Osborne Dentistry Registry #1356504-97 Doing business as

National Provider Directory

National Provider Directory

Locations

150 Market St
Lebanon, OR 97355
Phone (541) 451-4300

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527033600000",
    "number": "1003898073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MARKET ST",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973552334",
            "telephone_number": "541-451-4300",
            "fax_number": "541-451-4799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MARKET ST",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973552334",
            "telephone_number": "541-451-4300",
            "fax_number": "541-451-4799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTIAM DENTAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-16",
        "last_updated": "2018-05-23",
        "status": "A",
        "authorized_official_last_name": "OSBORNE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "541-451-4300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7346",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D5083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Osborne Dentistry Registry #1356504-97",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; 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.