Organization Active NPI

Oepackardddspllc

  • General Practice Dentistry
  • Vancouver, WA
National Provider Identifier
1073774113
Registry record updated Jun 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00010531 Issued in WA
Legal business name
OEPACKARDDDSPLLC
Practice address
9013 NE Highway 99
Suite M
Vancouver, WA 98665-8942
Phone
(360) 566-1400
Fax
(360) 566-1402
NPI assigned
Jun 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2008

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

Authorized official

Name
Dr. Matthew Carl Aldridge, D.M.D.
Title
Managing Dentist
Phone
(360) 566-1400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DE00010531 WA Primary

Addresses

Primary practice location

9013 NE Highway 99
Suite M
Vancouver, WA 98665-8942

Mailing address

9013 NE Highway 99
Suite M
Vancouver, WA 98665-8942
Phone (360) 566-1400

Other names 1

  • River Dental Doing business as

National Provider Directory

National Provider Directory

Locations

9013 NE Highway 99
Ste M
Vancouver, WA 98665
Phone (360) 566-1400

Practitioners & affiliated clinicians

Practitioners 1

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": "1213920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1073774113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9013 NE HIGHWAY 99",
            "address_2": "SUITE M",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986658942",
            "telephone_number": "360-566-1400",
            "fax_number": "360-566-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9013 NE HIGHWAY 99",
            "address_2": "SUITE M",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986658942",
            "telephone_number": "360-566-1400",
            "fax_number": "360-566-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OEPACKARDDDSPLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-20",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "ALDRIDGE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "CARL",
        "authorized_official_title_or_position": "MANAGING DENTIST",
        "authorized_official_telephone_number": "360-566-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00010531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.