Marc T. Iwahiro, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D7121 Issued in OR

Practice address

4600 River Rd N
Keizer, OR 97303-4648

Phone

(503) 393-2264

Fax

(503) 393-2324

NPI assigned

Feb 22, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Keizer Family Dental Care

  • General Practice Dentistry
  • Keizer, OR
  • NPI 1699034082
  NPD (past) Authorized official
• Darcy K Olander DMD LLC

  • Dental Clinic/Center
  • Keizer, OR
  • NPI 1043880719
  NPD (past)

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629103437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 RIVER RD N",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034648",
            "telephone_number": "503-393-2264",
            "fax_number": "503-393-2324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 RIVER RD N",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034648",
            "telephone_number": "503-393-2264",
            "fax_number": "503-393-2324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWAHIRO",
        "first_name": "MARC",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Hurst
• Kevin Michael Hussey, ATC, PTA
• Eileen Hyde, PT, DPT
• Inland Shores Family Dental
• Marcia Ann Ivie, OTR/L
• Tiffany Iwasa
• J & L Adult Care
• J & V Care Management, LLC (Synergy HomeCare of Salem)
• Sarah Jackson
• Emily Adele Jadhav

• General Practice Dentistry in Keizer, OR
• Providers in Keizer, OR by specialty
• General Practice Dentistry in Oregon

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.