NPIMap

Organization Active NPI

Eugene Dental Group

  • General Practice Dentistry
  • Eugene, OR
National Provider Identifier
1306221445
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D9649 Issued in OR
Legal business name
EUGENE DENTAL GROUP
Practice address
4750 Village Plaza Loop
Suite 200
Eugene, OR 97401-6601
Phone
(541) 683-8646
NPI assigned
Jul 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2015

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

Authorized official

Name
Elizabeth A. Vivona, D.D.S.
Title
Dentist
Phone
(541) 683-8646

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D9649 OR Primary

Addresses

Primary practice location

4750 Village Plaza Loop
Suite 200
Eugene, OR 97401-6601

Mailing address

4750 Village Plaza Loop
Suite 200
Eugene, OR 97401
Phone (541) 683-8646

Other names 1

  • Elizabeth A. Vivona Dow Other name

National Provider Directory

National Provider Directory

Locations

4750 Village Plaza Loop
Ste 200
Eugene, OR 97401
Phone (541) 683-8646

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438128000000",
    "number": "1306221445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 VILLAGE PLAZA LOOP",
            "address_2": "SUITE 200",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97401",
            "telephone_number": "541-683-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 VILLAGE PLAZA LOOP",
            "address_2": "SUITE 200",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974016601",
            "telephone_number": "541-683-8646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUGENE DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-29",
        "last_updated": "2015-07-29",
        "status": "A",
        "authorized_official_last_name": "VIVONA",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "541-683-8646",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elizabeth A. Vivona Dow",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.