NPIMap

Organization Active NPI

Western Denture Center Inc.

  • Denturist
  • Medford, OR
National Provider Identifier
1518070218
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DenturistTaxonomy code 122400000X
License
DT-DO-237679 Issued in OR
Legal business name
WESTERN DENTURE CENTER INC.
Practice address
1055 Court St
Medford, OR 97501-5727
Phone
(541) 773-3551
Fax
(541) 776-4911
NPI assigned
Aug 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
David R. Dahl, L.D.NPI 1518074673
Title
President
Phone
(541) 773-3551

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
DenturistGroup: 193400000X SINGLE SPECIALTY GROUP 122400000X DT-DO-237679 OR Primary

Addresses

Primary practice location

1055 Court St
Medford, OR 97501-5727

Mailing address

1055 Court St
Medford, OR 97501-5727
Phone (541) 773-3551

National Provider Directory

National Provider Directory

Locations

1055 Court St
Medford, OR 97501
Phone (541) 773-3551

Practitioners & affiliated clinicians

Practitioners 1

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": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518070218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 COURT ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975015727",
            "telephone_number": "541-773-3551",
            "fax_number": "541-776-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 COURT ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975015727",
            "telephone_number": "541-773-3551",
            "fax_number": "541-776-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN DENTURE CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAHL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-773-3551",
        "authorized_official_credential": "L.D."
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Denturist",
            "state": "OR",
            "license": "DT-DO-237679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.