NPIMap

Organization Active NPI

Oregon Pip Dental Group, PC

  • Pediatric Dentistry
  • The Dalles, OR
National Provider Identifier
1609113703
Registry record updated Oct 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
7666 Issued in OR
Legal business name
OREGON PIP DENTAL GROUP, PC
Practice address
1935 E 19TH St
The Dalles, OR 97058-3390
Phone
(541) 296-8901
NPI assigned
Jan 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2019

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

Authorized official

Name
Mellissa Renner
Title
Regional Operations Manager
Phone
(541) 667-4145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 7666 OR Primary

Addresses

Primary practice location

1935 E 19TH St
The Dalles, OR 97058-3390

Mailing address

1935 E 19TH St
The Dalles, OR 97058-3390
Phone (541) 296-8901

Other names 1

  • A Kidz Dental Zone of The Dalles Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570406400000",
    "number": "1609113703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 E 19TH ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583390",
            "telephone_number": "541-296-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 E 19TH ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583390",
            "telephone_number": "541-296-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON PIP DENTAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-09",
        "last_updated": "2019-10-07",
        "status": "A",
        "authorized_official_last_name": "RENNER",
        "authorized_official_first_name": "MELLISSA",
        "authorized_official_title_or_position": "REGIONAL OPERATIONS MANAGER",
        "authorized_official_telephone_number": "541-667-4145"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OR",
            "license": "7666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Kidz Dental Zone of The Dalles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in The Dalles, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; 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.