NPIMap

Organization Active NPI

Crisdental Central Point

  • General Practice Dentistry
  • Central Point, OR
National Provider Identifier
1275901712
Registry record updated Sep 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D8594 Issued in OR
Legal business name
CRISDENTAL CENTRAL POINT
Practice address
826 S Front St
Central Point, OR 97502-2726
Phone
(541) 727-3067
Fax
(866) 770-8050
NPI assigned
Sep 14, 2015
Organization subpart
Yes
Parent organization
CRISDENTAL PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 14, 2015

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

Authorized official

Name
Michael J Bratland, DMD
Title
Owner
Phone
(541) 492-1687

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D8594 OR Primary

Addresses

Primary practice location

826 S Front St
Central Point, OR 97502-2726

Mailing address

PO Box 2571
Roseburg, OR 97470-0436
Phone (541) 492-1687

National Provider Directory

National Provider Directory

Locations

826 S Front St
Central Point, OR 97502
Phone (541) 727-3067

NPI Registry JSON

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442188800000",
    "number": "1275901712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2571",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974700436",
            "telephone_number": "541-492-1687",
            "fax_number": "866-216-6527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 S FRONT ST",
            "city": "CENTRAL POINT",
            "state": "OR",
            "postal_code": "975022726",
            "telephone_number": "541-727-3067",
            "fax_number": "866-770-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRISDENTAL CENTRAL POINT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CRISDENTAL PC",
        "enumeration_date": "2015-09-14",
        "last_updated": "2015-09-14",
        "status": "A",
        "authorized_official_last_name": "BRATLAND",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-492-1687",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D8594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Central Point, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; 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.