NPIMap

Organization Active NPI

Jeffrey Carl DMD PC

  • General Practice Dentistry
  • Albany, OR
National Provider Identifier
1114063542
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D7214 Issued in OR
Legal business name
JEFFREY CARL DMD PC
Practice address
917 19TH Ave SE
Albany, OR 97322-4228
Phone
(541) 926-6089
Fax
(541) 926-6196
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jeffrey D Carl, DMDNPI 1821096751
Title
President
Phone
(541) 926-6089

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D7214 OR Primary

Addresses

Primary practice location

917 19TH Ave SE
Albany, OR 97322-4228

Mailing address

3683 NW Glen Eden Dr
Corvallis, OR 97330-9169
Phone (541) 752-0378

National Provider Directory

National Provider Directory

Locations

917 19th Ave SE
Albany, OR 97322
Phone (541) 926-6089

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": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114063542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3683 NW GLEN EDEN DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973309169",
            "telephone_number": "541-752-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 19TH AVE SE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973224228",
            "telephone_number": "541-926-6089",
            "fax_number": "541-926-6196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY CARL DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-926-6089",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.