Phillip R Dahl, L.D

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DT DO 869528 Issued in OR

Practice address

1663 W Harvard Ave
Roseburg, OR 97470-2812

Phone

(541) 672-0100

Fax

(541) 440-8996

NPI assigned

May 8, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194938894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14987 N BANK RD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974707937",
            "telephone_number": "541-496-3794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1663 W HARVARD AVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974702812",
            "telephone_number": "541-672-0100",
            "fax_number": "541-440-8996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHL",
        "first_name": "PHILLIP",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "L.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "OR",
            "license": "DT DO 869528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice Lee Cummins, CADC I
• Jeanie Michelle Curphey
• Mary Ann Curtiss, ANP-BC
• Philip Michael Cusack, OTR/L
• Larisa Ivana Czernowski
• Tyson Jarad Dahl, PA-C
• Gary B. Dandy, MD
• Daniel J. Olson DDS PHD PC
• Carol Lynn Daniels, RN
• Debra Ann Daniels, P.A.

• Prosthodontics in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Prosthodontics in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.