Active NPI
David J Washburn, D.M.D.
- General Practice Dentistry
- Roseburg, OR
National Provider Identifier
1336278357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5509
- Practice address
- 544 W. Umpqua St
Roseburg, OR 97470 - Phone
- (541) 672-9596
- Fax
- (541) 464-3519
- NPI assigned
- Mar 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 5509 | OR | Primary |
Addresses
Primary practice location
544 W. Umpqua St
Roseburg, OR 97470
Mailing address
544 W. Umpqua St
Roseburg, OR 97470
Phone (541) 672-9596
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009352000 | Other | OR | BLUE CROSS OF OR |
| 917114 | Other | OR | UNITED CONCORDIA |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5509 | OR | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219881600000",
"number": "1336278357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "544 W. UMPQUA ST",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "97470",
"telephone_number": "541-672-9596",
"fax_number": "541-464-3519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "544 W. UMPQUA ST",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "97470",
"telephone_number": "541-672-9596",
"fax_number": "541-464-3519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASHBURN",
"first_name": "DAVID",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-05",
"last_updated": "2008-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "5509",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF OR",
"identifier": "009352000",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "917114",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roseburg, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.