NPIMap

Organization Active NPI

Doctor Teeth DMD LLC

  • General Practice Dentistry
  • Grants Pass, OR
National Provider Identifier
1205426186
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DOCTOR TEETH DMD LLC
Practice address
200 NE Terry LN Unit D
Grants Pass, OR 97526-4805
Phone
(541) 237-8087
NPI assigned
Jan 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Authorized official

Name
Paul LamoreauNPI 1649831991
Title
Owner
Phone
(541) 237-8087

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
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

200 NE Terry LN Unit D
Grants Pass, OR 97526-4805

Mailing address

PO Box 70887
Cleveland, OH 44190-0887

National Provider Directory

National Provider Directory

Locations

200 NE Terry Ln
Unit D
Grants Pass, OR 97526
Phone (541) 237-8087

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687219200000",
    "number": "1205426186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70887",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441900887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NE TERRY LN UNIT D",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975264805",
            "telephone_number": "541-237-8087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTOR TEETH DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-25",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A",
        "authorized_official_last_name": "LAMOREAU",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-237-8087"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "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 Jun 20, 2023; 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.