NPIMap

Organization Active NPI

Rogue River Denture Service

  • Dental Laboratory
  • Grants Pass, OR
National Provider Identifier
1154873271
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental LaboratoryTaxonomy code 292200000X
License
DT-DO-093102 Issued in OR
Legal business name
ROGUE RIVER DENTURE SERVICE
Practice address
1850 Williams Hwy
Grants Pass, OR 97527-5662
Phone
(541) 476-0254
Fax
(541) 955-7277
NPI assigned
Oct 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Authorized official

Name
Mitchell K. Sheeler, L.DNPI 1952741969
Title
Denturist
Phone
(541) 476-0254

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
Dental Laboratory 292200000X DT-DO-093102 OR Primary

Addresses

Primary practice location

1850 Williams Hwy
Grants Pass, OR 97527-5662

Mailing address

1850 Williams Hwy
Grants Pass, OR 97527-5662
Phone (541) 476-0254

National Provider Directory

National Provider Directory

Locations

1850 Williams Hwy
Grants Pass, OR 97527
Phone (541) 476-0254

Practitioners & affiliated clinicians

Practitioners 2

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": "1477353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477353600000",
    "number": "1154873271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 WILLIAMS HWY",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275662",
            "telephone_number": "541-476-0254",
            "fax_number": "541-955-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 WILLIAMS HWY",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275662",
            "telephone_number": "541-476-0254",
            "fax_number": "541-955-7277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGUE RIVER DENTURE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-25",
        "last_updated": "2016-10-25",
        "status": "A",
        "authorized_official_last_name": "SHEELER",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "DENTURIST",
        "authorized_official_telephone_number": "541-476-0254",
        "authorized_official_credential": "L.D"
    },
    "taxonomies": [
        {
            "code": "292200000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory",
            "state": "OR",
            "license": "DT-DO-093102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.