Gold Beach Family Dental Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

4990 Issued in OR

Legal business name

GOLD BEACH FAMILY DENTAL INC

Practice address

94223 4TH St
Gold Beach, OR 97444

Phone

(541) 247-7332

Fax

(541) 247-9204

NPI assigned

Sep 20, 2006

Last updated

Feb 13, 2008By 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

Thomas Wayne Westfall, DMDNPI 1639356512

Title

President Owner

Phone

(541) 247-7332

Specialties & licenses 1

Addresses

Other identifiers 2

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.

• Thomas Wayne Westfall, DMD

  • General Practice Dentistry
  • Gold Beach, OR
  • NPI 1639356512
  NPD (past) Authorized official

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202860800000",
    "number": "1538266713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772",
            "city": "GOLD BEACH",
            "state": "OR",
            "postal_code": "97444",
            "telephone_number": "541-247-7332",
            "fax_number": "541-247-9204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94223 4TH ST",
            "city": "GOLD BEACH",
            "state": "OR",
            "postal_code": "97444",
            "telephone_number": "541-247-7332",
            "fax_number": "541-247-9204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD BEACH FAMILY DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-02-13",
        "status": "A",
        "authorized_official_last_name": "WESTFALL",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "541-247-7332",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": "4990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMAP",
            "identifier": "215277",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHP",
            "identifier": "IJUP6C-00",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy Gamble
• Michael Paul Gardner, M.D.
• Ryan James Girard, LAC
• Vannesza Eunice Girard, L.AC.
• Satyendra Giri, M.D.
• Gold Beach Pharmacy LLC
• Evelin Gonzales
• Laura Greathead, LMT
• Jean E Hale, PSY.D.
• Rhonda Hale, PT

• Dental Clinic/Center in Gold Beach, OR
• Providers in Gold Beach, OR by specialty
• Dental Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.