Creekside Family Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

1700042313 Issued in OR

Legal business name

CREEKSIDE FAMILY DENTAL

Practice address

1234 N Riverside Ave
Medford, OR 97501-4619

Phone

(541) 773-3756

NPI assigned

Oct 4, 2016

Last updated

Oct 4, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Angie Holmes

Title

Office Manager

Phone

(541) 773-3756

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475539200000",
    "number": "1174073043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 N RIVERSIDE AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975014619",
            "telephone_number": "541-773-3756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 N RIVERSIDE AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975014619",
            "telephone_number": "541-773-3756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-04",
        "last_updated": "2016-10-04",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "541-773-3756"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": "1700042313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hailey Nicole Crawford, PTA
• Holt Crawford
• Robert Crawford, PSS, CRM
• Sarah L Crawford, NP
• CRC Health Oregon, LLC (Allied Health Services Medford)
• Creekside Family Medicine, LLC (Creekside Family Medicine)
• Chloe Creel, CSWA, QMHP
• Jacob Hunter Creighton, MD
• Glenda Lea Crenshaw
• Claudia Crespo

• Dental Clinic/Center in Medford, OR
• Providers in Medford, OR by specialty
• Dental Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.