South Lane Children'S Dental Clinic

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

Legal business name

SOUTH LANE CHILDREN'S DENTAL CLINIC

Practice address

1275 S River Rd
Cottage Grove, OR 97424-3906

Phone

(541) 520-7137

NPI assigned

Apr 29, 2013

Organization subpart

Yes

Parent organization

SOUTH LANE SCHOOL DISTRICTAs reported in NPPES

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

Authorized official

Name

Mrs. Courtney Jane Long, EFDA

Title

Dental Care Coordinator

Phone

(541) 520-7137

Specialties & licenses 1

Addresses

Tax ID family

South Lane Children'S Dental Clinic2 organizations share this tax ID, including this one

Part of

South Lane Children'S Dental Clinic

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• S Lane County School District 45J3

  • Local Education Agency (LEA)
  • Cottage Grove, OR
  • NPI 1700959269
  NPD tax ID

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1497190821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 S RIVER RD",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974243906",
            "telephone_number": "541-520-7137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 S RIVER RD",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974243906",
            "telephone_number": "541-520-7137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH LANE CHILDREN'S DENTAL CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH LANE SCHOOL DISTRICT",
        "enumeration_date": "2013-04-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "DENTAL CARE COORDINATOR",
        "authorized_official_telephone_number": "541-520-7137",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "EFDA"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Smith, QMHA- PEER SUPPORT
• Suzanne M. Snellen, GNP
• Sol Transit Assisted Oregon Corp
• Jose Arnulfo Solis, D.O.
• Noeul Song
• South Lane County Fire and Rescue
• South Lane Mental Health Services, Inc
• South Lane Mental Health Services, Inc
• South Lane Physical Therapy LLC
• South Lane Wheels, Inc.

• Voluntary or Charitable Agency in Cottage Grove, OR
• Providers in Cottage Grove, OR by specialty
• Voluntary or Charitable Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.