Jeff Van Kirk, DMD, PC

Organization Active NPI General Practice Dentistry · Stayton, OR

NPI 1124440417 · NPPES record last updated Jan 6, 2014

Key facts

NPI
1124440417
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
D9848 (OR)
Legal business name
JEFF VAN KIRK, DMD, PC
Practice address
450 E Washington St
Stayton, OR 97383-1837
Phone
(503) 769-6351
Fax
(503) 759-7029
NPI assigned
Jan 6, 2014
Organization subpart
No

Authorized official

Name
Dr. Jeff Scott Van Kirk, DMD
Title
President, General Dentist
Phone
(216) 394-3140

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

450 E Washington St
Stayton, OR 97383
Phone (503) 769-6351

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X D9848 OR Yes

Addresses

Primary practice location

450 E Washington St
Stayton, OR 97383-1837

Mailing address

1390 Alpine Lakes St SE
Salem, OR 97317-6976
Phone (216) 394-3140

Other providers in Stayton, OR

All providers in Stayton, OR · General Practice Dentistry in Oregon

Sources for this page

Verify at the official NPI Registry.