David Mark McCollough, DMD MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

4022 Issued in AL

Practice address

3750 Chemawa Rd NE
Chemawa Indian Health Center
Salem, OR 97305-1111

Phone

(503) 304-7600

Fax

(503) 304-7677

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1265476188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 CHEMAWA RD NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051111",
            "telephone_number": "503-304-7664",
            "fax_number": "503-304-7677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 CHEMAWA RD NE",
            "address_2": "CHEMAWA INDIAN HEALTH CENTER",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973051111",
            "telephone_number": "503-304-7600",
            "fax_number": "503-304-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLOUGH",
        "first_name": "DAVID",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DMD MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AL",
            "license": "4022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278159",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily McCloud-Blackburn
• Lisa McCloud
• Jean McCloy
• Elizabeth Lenore McClure, AA DEGREE
• Rana McCollam
• Kimberly Renee McCollum, PSYD
• Pamela Lynn McCollum, LCSW
• Blake McConnell, MD
• Amy McCormick
• Christina Marie McCormick, COTA/L

• Orthodontics and Dentofacial Orthopedics Dentistry in Salem, OR
• Providers in Salem, OR by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.