Active NPI
Ronald Graham McEntire, DDS
- General Practice Dentistry
- Pendleton, OR
National Provider Identifier
1063545366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D10341
- Practice address
- 1100 Southgate Ste 3
Pendleton, OR 97801 - Phone
- (541) 276-5272
- Fax
- (541) 276-7212
- NPI assigned
- Mar 14, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE00007097 | WA | |
| General Practice Dentistry | 1223G0001X | D10341 | OR | Primary |
Addresses
Primary practice location
1100 Southgate Ste 3
Pendleton, OR 97801
Mailing address
1100 Southgate Ste 3
Pendleton, OR 97801
Phone (541) 276-5272
Other names 1
- R Graham McEntire
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE00007097 | WA | MD | Dentist |
| D10341 | OR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Martin & Sharkey PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dental Clinic/Center
- Walla Walla, WA
- NPI 1891936399
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638144000000",
"number": "1063545366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 SOUTHGATE STE 3",
"city": "PENDLETON",
"state": "OR",
"postal_code": "97801",
"telephone_number": "541-276-5272",
"fax_number": "541-276-7212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 SOUTHGATE STE 3",
"city": "PENDLETON",
"state": "OR",
"postal_code": "97801",
"telephone_number": "541-276-5272",
"fax_number": "541-276-7212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCENTIRE",
"first_name": "RONALD",
"middle_name": "GRAHAM",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-14",
"last_updated": "2021-11-29",
"certification_date": "2021-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE00007097",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "D10341",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "R GRAHAM",
"last_name": "MCENTIRE",
"credential": "DDS",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Pendleton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.