Chief Joseph Dental Clinic, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

CHIEF JOSEPH DENTAL CLINIC, LLC

Practice address

401 B North Main Street
Joseph, OR 97846

Phone

(541) 432-6555

Fax

(541) 432-5051

NPI assigned

Jul 26, 2010

Last updated

Jul 26, 2010By 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. Steven R ZollmanNPI 1679664114

Title

Owner

Phone

(541) 432-6555

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.

• Steven Ray Zollman, D.M.D.

  • General Practice Dentistry
  • San Jose, CA
  • NPI 1679664114
  NPD (past) Authorized official

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280102400000",
    "number": "1285947721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 B NORTH MAIN STREET",
            "city": "JOSEPH",
            "state": "OR",
            "postal_code": "97846",
            "telephone_number": "541-432-6555",
            "fax_number": "541-432-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 B NORTH MAIN STREET",
            "city": "JOSEPH",
            "state": "OR",
            "postal_code": "97846",
            "telephone_number": "541-432-6555",
            "fax_number": "541-432-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIEF JOSEPH DENTAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-26",
        "last_updated": "2010-07-26",
        "status": "A",
        "authorized_official_last_name": "ZOLLMAN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-432-6555",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol L Baynes, R.N.
• Blue Butterfly Services LLC (Blue Butterfly Mental Health LLC)
• R. Devee Boyd, M.D.
• Kirsten Elizabeth Tallent Caine, MD
• Sandra N Catlin, LCSW
• Mollie Elizabeth Cudmore, MSW
• Kuulei Delatori, RDH
• Risa Frank
• Traci M. Frye, R.N., F.N.P.
• Amy Jacqueline Gulzow, LMT

• Dental Clinic/Center in Joseph, OR
• Providers in Joseph, OR by specialty
• Dental Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2010; 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.