Crisdental Lincoln City, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D8594 Issued in OR

Legal business name

CRISDENTAL LINCOLN CITY, LLC

Practice address

2604 NE Highway 101
Lincoln City, OR 97367-4460

Phone

(541) 492-1687

NPI assigned

Jul 20, 2016

Organization subpart

Yes

Parent organization

CRISDENTAL PCAs reported in NPPES

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

Authorized official

Name

Dr. Michael J Bratland, DMD

Title

Owner

Phone

(541) 492-1687

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468972800000",
    "number": "1154774677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1361",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974700334",
            "telephone_number": "541-492-1687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 NE HIGHWAY 101",
            "city": "LINCOLN CITY",
            "state": "OR",
            "postal_code": "973674460",
            "telephone_number": "541-492-1687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRISDENTAL LINCOLN CITY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CRISDENTAL PC",
        "enumeration_date": "2016-07-20",
        "last_updated": "2016-07-20",
        "status": "A",
        "authorized_official_last_name": "BRATLAND",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-492-1687",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D8594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corvallis Clinic PC
• Costal Support Services
• County of Lincoln
• County of Lincoln
• Creative Connection Counseling
• Rebecca Joyce Cude
• Theresa J Curran, PA-C
• Belinda Joy Dagaas, PHARMD
• Alana M Dannen, DPT
• Darrell D Prins

• All providers in Lincoln City, OR
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; 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.