NPIMap

Organization Active NPI

K & L Oms LLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Bend, OR
National Provider Identifier
1063942043
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
Legal business name
K & L OMS LLC
Practice address
1475 SW Chandler Ave Ste 101
Bend, OR 97702-3239
Phone
(541) 617-3993
Fax
(541) 617-0030
NPI assigned
Jun 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Authorized official

Name
Keith E Krueger, D.M.D.NPI 1720044126
Title
Owner
Phone
(541) 617-3993

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
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X D6629 OR
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X Primary

Addresses

Primary practice location

1475 SW Chandler Ave Ste 101
Bend, OR 97702-3239

Mailing address

1475 SW Chandler Ave Ste 101
Bend, OR 97702-3239
Phone (541) 617-3993

National Provider Directory

National Provider Directory
Tax ID family
K L Oms LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

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": "1497312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673308800000",
    "number": "1063942043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 SW CHANDLER AVE STE 101",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023239",
            "telephone_number": "541-617-3993",
            "fax_number": "541-617-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 SW CHANDLER AVE STE 101",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023239",
            "telephone_number": "541-617-3993",
            "fax_number": "541-617-0030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K & L OMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-13",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A",
        "authorized_official_last_name": "KRUEGER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-617-3993",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OR",
            "license": "D6629",
            "primary": false
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.