NPIMap

Organization Active NPI

Peter T Raven DDS LLC

  • Dental Clinic/Center
  • Springfield, OR
National Provider Identifier
1619264272
Registry record updated Jul 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D9085 Issued in OR
Legal business name
PETER T RAVEN DDS LLC
Practice address
222 6TH St
Springfield, OR 97477-4602
Phone
(541) 726-1961
NPI assigned
Jul 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2011

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

Authorized official

Name
Peter Tyler Raven, DDSNPI 1700036878
Title
Manager
Phone
(541) 726-1961

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
Dental Clinic/Center 261QD0000X D9085 OR Primary

Addresses

Primary practice location

222 6TH St
Springfield, OR 97477-4602

Mailing address

222 6TH St
Springfield, OR 97477-4602
Phone (541) 726-1961

National Provider Directory

National Provider Directory

Locations

222 6th St
Springfield, OR 97477
Phone (541) 726-1961

Practitioners & affiliated clinicians

Practitioners 2

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": "1309824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309824000000",
    "number": "1619264272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 6TH ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774602",
            "telephone_number": "541-726-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 6TH ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774602",
            "telephone_number": "541-726-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER T RAVEN DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-05",
        "last_updated": "2011-07-05",
        "status": "A",
        "authorized_official_last_name": "RAVEN",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "TYLER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "541-726-1961",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": "D9085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2011; 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.