Fourth Street Family Dental, PC

Primary specialty

DentistTaxonomy code 122300000X

License

D6986 Issued in OR

Legal business name

FOURTH STREET FAMILY DENTAL, PC

Practice address

530 SE 4TH St
Hermiston, OR 97838-2416

Phone

(541) 567-1693

Fax

(541) 567-2840

NPI assigned

Jan 15, 2014

Last updated

Jan 15, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Gregory B Jones, DMDNPI 1033116751

Title

Owner

Phone

(541) 567-1693

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gregory B Jones, D.M.D.

  • General Practice Dentistry
  • Hermiston, OR
  • NPI 1033116751
  NPD (past) Authorized official

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389744000000",
    "number": "1447672142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 SE 4TH STREET",
            "city": "HERMISTON",
            "state": "OR",
            "postal_code": "97838",
            "telephone_number": "541-567-1693",
            "fax_number": "541-567-2840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 SE 4TH ST",
            "city": "HERMISTON",
            "state": "OR",
            "postal_code": "978382416",
            "telephone_number": "541-567-1693",
            "fax_number": "541-567-2840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOURTH STREET FAMILY DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-15",
        "last_updated": "2014-01-15",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-567-1693",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OR",
            "license": "D6986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jana Flatau
• Joseph Fleck
• Delwin Gary Flint, O.D.
• Isabella Flores-Merritt, MD
• Cynthia Flores
• Naamah Franke
• Trux French
• Fresenius Medical Care Dialysis Services - Oregon, (FMC Dialysis Services of Hermiston)
• James Charles Fulper, MD MRO
• G. Adam Fulton, DDS

• Dentist in Hermiston, OR
• Providers in Hermiston, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.