NPIMap

Organization Active NPI

Eugene Kids' Dentist, LLC

  • Pediatric Dentistry
  • Eugene, OR
National Provider Identifier
1366738858
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
EUGENE KIDS' DENTIST, LLC
Practice address
4122 Quest Dr.
Eugene, OR 97402
Phone
(541) 844-1667
NPI assigned
Jun 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2014

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

Authorized official

Name
Timothy Richardson, DDSNPI 1184855967
Title
Dr. / Owner
Phone
(541) 844-1667

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

4122 Quest Dr.
Eugene, OR 97402

Mailing address

4122 Quest Dr.
Eugene, OR 97402
Phone (541) 844-1667

Other names 1

  • A Kidz Dental Zone of Eugene, LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

4122 Quest Dr
Eugene, OR 97402
Phone (541) 359-3261

Practitioners & affiliated clinicians

Practitioners 3

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": "1308700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402963200000",
    "number": "1366738858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4122 QUEST DR.",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97402",
            "telephone_number": "541-844-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4122 QUEST DR.",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97402",
            "telephone_number": "541-844-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUGENE KIDS' DENTIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-22",
        "last_updated": "2014-06-17",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "DR. / OWNER",
        "authorized_official_telephone_number": "541-844-1667",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Kidz Dental Zone of Eugene, LLC",
            "code": "4",
            "type": "Former Legal Business 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 Jun 17, 2014; 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.