NPIMap

Organization Active NPI

Northwest Dental Group, PC-Lapine

  • General Practice Dentistry
  • La Pine, OR
National Provider Identifier
1467596528
Registry record updated Mar 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D7823 Issued in OR
Legal business name
NORTHWEST DENTAL GROUP, PC-LAPINE
Practice address
16475 Bluewood Place
Lapine, OR 97739-2999
Phone
(541) 536-0264
Fax
(541) 536-0266
NPI assigned
Feb 20, 2007
Last updated
Mar 31, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2008

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

Authorized official

Name
Dr. Jonathan A Yang, DDSNPI 1003082652
Title
President
Phone
(541) 536-0264

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
General Practice Dentistry 1223G0001X D7823 OR Primary

Addresses

Primary practice location

16475 Bluewood Place
Lapine, OR 97739-2999

Mailing address

16475 Bluewood Place
PO Box 2999
Lapine, OR 97739-2999
Phone (541) 536-0264

National Provider Directory

National Provider Directory

Locations

16475 Bluewood Pl
La Pine, OR 97739
Phone (541) 536-0264

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206921600000",
    "number": "1467596528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16475 BLUEWOOD PLACE",
            "address_2": "PO BOX 2999",
            "city": "LAPINE",
            "state": "OR",
            "postal_code": "977392999",
            "telephone_number": "541-536-0264",
            "fax_number": "541-536-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16475 BLUEWOOD PLACE",
            "city": "LAPINE",
            "state": "OR",
            "postal_code": "977392999",
            "telephone_number": "541-536-0264",
            "fax_number": "541-536-0266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST DENTAL GROUP, PC-LAPINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2008-03-31",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-536-0264",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Pine, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.

Verify at the official NPI Registry.