NPIMap

Organization Active NPI

Rogue Dental Sleep Solutions LLC

  • General Practice Dentistry
  • Grants Pass, OR
National Provider Identifier
1225670623
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ROGUE DENTAL SLEEP SOLUTIONS LLC
Practice address
124 NE Evelyn Ave
Grants Pass, OR 97526-1427
Phone
(206) 818-0492
NPI assigned
Oct 17, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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

Authorized official

Name
Michael Holm, DDSNPI 1891020806
Title
Owner
Phone
(206) 818-0492

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 SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

124 NE Evelyn Ave
Grants Pass, OR 97526-1427

Mailing address

124 NE Evelyn Ave
Grants Pass, OR 97526-1427
Phone (541) 936-9456

National Provider Directory

National Provider Directory

Locations

124 NE Evelyn Ave
Grants Pass, OR 97526
Phone (206) 818-0492

Practitioners & affiliated clinicians

Practitioners 1

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": "1571270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575849600000",
    "number": "1225670623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 NE EVELYN AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261427",
            "telephone_number": "541-936-9456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 NE EVELYN AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975261427",
            "telephone_number": "206-818-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGUE DENTAL SLEEP SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-17",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A",
        "authorized_official_last_name": "HOLM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-818-0492",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X 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 Dec 9, 2019; 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.