NPIMap

Organization Active NPI

Medical Center Dental, LLC

  • General Practice Dentistry
  • Pendleton, OR
National Provider Identifier
1285903047
Registry record updated Dec 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D9454 Issued in OR
Legal business name
MEDICAL CENTER DENTAL, LLC
Practice address
1100 Southgate
Suite 17
Pendleton, OR 97801-3974
Phone
(541) 276-1561
Fax
(541) 276-5743
NPI assigned
Dec 23, 2011
Last updated
Dec 23, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2011

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

Authorized official

Name
Dr. Jason Lamar Walker, DMDNPI 1497068662
Title
Owner
Phone
(541) 276-1561

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X D9425 OR
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X D9454 OR Primary

Addresses

Primary practice location

1100 Southgate
Suite 17
Pendleton, OR 97801-3974

Mailing address

1100 Southgate
Suite 17
Pendleton, OR 97801-3974
Phone (541) 276-1561

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1324598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324598400000",
    "number": "1285903047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 SOUTHGATE",
            "address_2": "SUITE 17",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978013974",
            "telephone_number": "541-276-1561",
            "fax_number": "541-276-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 SOUTHGATE",
            "address_2": "SUITE 17",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978013974",
            "telephone_number": "541-276-1561",
            "fax_number": "541-276-5743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-23",
        "last_updated": "2011-12-23",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "LAMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-276-1561",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9425",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pendleton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2011; 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.