NPIMap

Organization Active NPI

Willamette Valley Oral & Maxillofacial Surgey, Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Salem, OR
National Provider Identifier
1144575267
Registry record updated Jul 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
D6858 Issued in OR
Legal business name
WILLAMETTE VALLEY ORAL & MAXILLOFACIAL SURGEY, INC.
Practice address
250 Church St SE Ste 102
Salem, OR 97301-3758
Phone
(503) 581-1999
Fax
(503) 581-1107
NPI assigned
Jul 15, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2012

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

Authorized official

Name
Holly J Eyre
Title
Office Manager
Phone
(503) 581-1999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X D6858 OR Primary

Addresses

Primary practice location

250 Church St SE Ste 102
Salem, OR 97301-3758

Mailing address

250 Church St SE Ste 102
Salem, OR 97301-3758
Phone (503) 581-1999

National Provider Directory

National Provider Directory

Locations

250 Church St SE
Ste 102
Salem, OR 97301
Phone (503) 581-1999

NPI Registry JSON

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

{
    "created_epoch": "1342310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342310400000",
    "number": "1144575267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 CHURCH ST SE STE 102",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013758",
            "telephone_number": "503-581-1999",
            "fax_number": "503-581-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CHURCH ST SE STE 102",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013758",
            "telephone_number": "503-581-1999",
            "fax_number": "503-581-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLAMETTE VALLEY ORAL & MAXILLOFACIAL SURGEY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-15",
        "last_updated": "2012-07-15",
        "status": "A",
        "authorized_official_last_name": "EYRE",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "503-581-1999"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OR",
            "license": "D6858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2012; 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.