Individual provider Active NPI

Eric Noland Alston, DMD

  • General Practice Dentistry
  • Bend, OR
National Provider Identifier
1194165878
Registry record updated Feb 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D9888 Issued in OR
Practice address
62968 O B Riley Rd Ste 12
Bend, OR 97703
Phone
(855) 433-6825
NPI assigned
Jun 26, 2013
Last updated
Feb 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D9888 OR Primary

Addresses

Primary practice location

62968 O B Riley Rd Ste 12
Bend, OR 97703

Mailing address

6950 NE Campus Way
Hillsboro, OR 97124-5611
Phone (855) 433-6825

Other practice location 1

1123 E Main St
Medford, OR 97504-7434
Phone (541) 773-3422

Other practice location 2

1123 E Main St
Medford, OR 97504-7434
Phone (541) 773-3422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150302002196 OR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3779809173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
East Main Dental Center, LLP General Practice Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ealston269882@direct.ochin.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549843200000",
    "number": "1194165878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6950 NE CAMPUS WAY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245611",
            "telephone_number": "855-433-6825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62968 O B RILEY RD STE 12",
            "city": "BEND",
            "state": "OR",
            "postal_code": "97703",
            "telephone_number": "855-433-6825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1123 E Main St",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975047434",
            "country_code": "US",
            "telephone_number": "541-773-3422",
            "fax_number": "541-779-2250",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1123 E Main St",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975047434",
            "country_code": "US",
            "telephone_number": "541-773-3422",
            "fax_number": "541-779-2250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALSTON",
        "first_name": "ERIC",
        "middle_name": "NOLAND",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-26",
        "last_updated": "2019-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.