Active NPI
Matthew Bauer
- General Practice Dentistry
- Burns, OR
National Provider Identifier
1497844377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D8282
- Practice address
- 555 W Adams St
Burns, OR 97720-1408 - Phone
- (541) 573-7778
- NPI assigned
- Oct 11, 2006
- Sex
- Male
- Sole proprietor
- No
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 | D8282 | OR | Primary |
Addresses
Primary practice location
555 W Adams St
Burns, OR 97720-1408
Mailing address
213 N. Roanoke
PO Box 52
Hines, OR 97738
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 229011 | Medicaid | OR |
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 |
|---|---|---|---|
| D8282 | OR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Burns Dental Group LLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Burns, OR
- NPI 1053489013
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497844377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "213 N. ROANOKE",
"address_2": "PO BOX 52",
"city": "HINES",
"state": "OR",
"postal_code": "97738"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "555 W ADAMS ST",
"city": "BURNS",
"state": "OR",
"postal_code": "977201408",
"telephone_number": "541-573-7778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUER",
"first_name": "MATTHEW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "D8282",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "229011",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burns, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.