Active NPI
Douglas George Maddess, DMD
- General Practice Dentistry
- Cottage Grove, OR
National Provider Identifier
1326140377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D6737
- Practice address
- 914 S 4TH St
Cottage Grove, OR 97424-2702 - Phone
- (541) 942-1559
- Fax
- (541) 942-0827
- NPI assigned
- Sep 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D6737 | OR | Primary |
Addresses
Primary practice location
914 S 4TH St
Cottage Grove, OR 97424-2702
Mailing address
914 S 4TH St
Cottage Grove, OR 97424-2702
Phone (541) 942-1559
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D6737 | OR | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326140377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "914 S 4TH ST",
"city": "COTTAGE GROVE",
"state": "OR",
"postal_code": "974242702",
"telephone_number": "541-942-1559",
"fax_number": "541-942-0827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "914 S 4TH ST",
"city": "COTTAGE GROVE",
"state": "OR",
"postal_code": "974242702",
"telephone_number": "541-942-1559",
"fax_number": "541-942-0827"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADDESS",
"first_name": "DOUGLAS",
"middle_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "D6737",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cottage Grove, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.