Crisdental Mobile, LLC

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

Legal business name

CRISDENTAL MOBILE, LLC

Practice address

2530 NW Medical Park Dr
Roseburg, OR 97471-5510

Phone

(541) 673-6511

Fax

(541) 672-2757

NPI assigned

Jul 9, 2013

Last updated

Jul 9, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

CRISDENTAL PCAs reported in NPPES

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

Authorized official

Name

Dr. Michael James Bratland, DDSNPI 1235128745

Title

Owner

Phone

(541) 672-2747

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Jacob Bratland, DMD

  • General Practice Dentistry
  • Roseburg, OR
  • NPI 1235128745
  Authorized official Same address or phone

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373328000000",
    "number": "1043651896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3019 NW STEWART PKWY",
            "address_2": "STE 304, BOX 249",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711602",
            "telephone_number": "541-672-2747",
            "fax_number": "541-672-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 NW MEDICAL PARK DR",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974715510",
            "telephone_number": "541-673-6511",
            "fax_number": "541-672-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRISDENTAL MOBILE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CRISDENTAL PC",
        "enumeration_date": "2013-07-09",
        "last_updated": "2013-07-09",
        "status": "A",
        "authorized_official_last_name": "BRATLAND",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-672-2747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hunter Aaron Creech
• Rachel Cress
• Cassandre Cressall, PMHNP-BC
• Amber Cripe
• Cris Dental Group PC
• Edith Lynn Cronk, LCSW
• Jazmin Crookes, MA, LPC
• Michaela Cross, CHW
• Shelli Cross
• Anna Crumrine, PA-C

• Dental Hygienist in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Dental Hygienist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2013; 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.