Individual provider Active NPI

Terri Leanne Baarstad, DMD

  • General Practice Dentistry
  • Eugene, OR
National Provider Identifier
1124014600
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D7914 Issued in OR
Practice address
2921 Crescent Ave Ste 210
Eugene, OR 97408-7586
Phone
(541) 683-8396
Fax
(541) 984-1445
NPI assigned
Sep 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D7914 OR Primary

Addresses

Primary practice location

2921 Crescent Ave Ste 210
Eugene, OR 97408-7586

Mailing address

2921 Crescent Ave Ste 210
Eugene, OR 97408-7586
Phone (541) 683-8396

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160107001459 OR Order and Referring Only - DentistPractitioner - Dentist 6305148362

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1124014600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 CRESCENT AVE STE 210",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974087586",
            "telephone_number": "541-683-8396",
            "fax_number": "541-984-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 CRESCENT AVE STE 210",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974087586",
            "telephone_number": "541-683-8396",
            "fax_number": "541-984-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAARSTAD",
        "first_name": "TERRI",
        "middle_name": "LEANNE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-21",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.