Active NPI
Brian S. Bishop, DMD
- Pediatric Dentistry
- Medford, OR
National Provider Identifier
1073772299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- D9489
- Practice address
- 925 Town Centre Dr
Medford, OR 97504-6186 - Phone
- (541) 772-0102
- NPI assigned
- Jun 3, 2008
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | D9489 | OR | Primary |
| Pediatric Dentistry | 1223P0221X | D7527 | AZ |
Addresses
Primary practice location
925 Town Centre Dr
Medford, OR 97504-6186
Mailing address
925 Town Centre Dr
Medford, OR 97504-6186
Phone (541) 772-0102
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 |
|---|---|---|---|
| D7527 | AZ | MD | Pediatric Dentist |
| D9489 | OR | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308009600000",
"number": "1073772299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "925 TOWN CENTRE DR",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975046186",
"telephone_number": "541-772-0102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 TOWN CENTRE DR",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975046186",
"telephone_number": "541-772-0102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BISHOP",
"first_name": "BRIAN",
"middle_name": "S.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-03",
"last_updated": "2011-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "OR",
"license": "D9489",
"primary": true
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "AZ",
"license": "D7527",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.