Daniel Jordan Decillis, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11005 Issued in OR

Practice address

1144 Iowa St Ste a
Ashland, OR 97520

Phone

(541) 482-4995

NPI assigned

Apr 12, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Daniel J. Decillis, DDS, LLC

  • Dental Clinic/Center
  • Ashland, OR
  • NPI 1508428954
  NPD (past) Authorized official
• Peregrine Pacific Anesthesia PLLC

  • Anesthesiology Physician
  • Seattle, WA
  • NPI 1891065595
  NPD (past)
• Winston & Letwin DDS, PLLC

  • General Practice Dentistry
  • Seattle, WA
  • NPI 1669655767
  NPD (past)

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562371200000",
    "number": "1326545625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 IOWA ST STE A",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975202385",
            "telephone_number": "541-482-4995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 IOWA ST STE A",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "97520",
            "telephone_number": "541-482-4995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4915 25th Ave NE Ste 205",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981055668",
            "country_code": "US",
            "telephone_number": "206-524-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DECILLIS",
        "first_name": "DANIEL",
        "middle_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-12",
        "last_updated": "2019-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D11005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Davis
• Krystal Danielle Davis
• Nichole Day, LCSW
• Rochelle De Forrest
• Lindsey De la Vega, COTA
• Steven Duane Decker, O.D.
• Anthony B Dejack, MS
• Rebecca Delforge
• John P Delgado, MD
• Susan Demarinis, D.C.

• General Practice Dentistry in Ashland, OR
• Providers in Ashland, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.