Southside Dental PC

Primary specialty

DentistTaxonomy code 122300000X

License

D7830 Issued in OR

Legal business name

SOUTHSIDE DENTAL PC

Practice address

3460 Liberty Rd S
Salem, OR 97302-4607

Phone

(503) 763-9797

Fax

(503) 763-9779

NPI assigned

Jan 3, 2008

Last updated

Jan 3, 2008By 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

Dr. Jennifer P. OwensNPI 1922283316

Title

Doctor

Phone

(503) 763-9797

Specialties & licenses 1

Addresses

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.

• Jennifer P. Owens, DDS

  • Dentist
  • Salem, OR
  • NPI 1922283316
  Authorized official Same address or phone

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1235314667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3460 LIBERTY RD S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024607",
            "telephone_number": "503-763-9797",
            "fax_number": "503-763-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 LIBERTY RD S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024607",
            "telephone_number": "503-763-9797",
            "fax_number": "503-763-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "OWENS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "503-763-9797",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D7830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Salem Rehabilitation, Inc.
• South Salem Rehabilitation, LLC (Salem Transitional Care)
• South Sound Inpatient Physicians PLLC (Sound Inpatient Physicians)
• Kyler Hart Southcott
• Southern Hills Assisted Living Community, LLC (Southern Hills Assisted Living Community)
• James Richard Southworth, D.M.D.
• Kristi Souza
• Andrew Sowles, PHARMD, BCACP, BCPS
• Shannon Dwayne Spahan, STUDENT COUNSELOR
• Katherine Spann, MS, RDN, LD, CDE

• Dentist in Salem, OR
• Providers in Salem, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; 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.