Individual provider Active NPI

Kevin R Coombe, DMD

  • General Practice Dentistry
  • Redmond, OR
National Provider Identifier
1629220058
Registry record updated Oct 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D6510C Issued in OR
Practice address
774 SW Rimrock Way
Redmond, OR 97756-1941
Phone
(541) 923-7633
Fax
(541) 923-8733
NPI assigned
Oct 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D6510C OR Primary

Addresses

Primary practice location

774 SW Rimrock Way
Redmond, OR 97756-1941

Mailing address

774 SW Rimrock Way
Redmond, OR 97756-1941
Phone (541) 923-7633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224115200000",
    "number": "1629220058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "774 SW RIMROCK WAY",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561941",
            "telephone_number": "541-923-7633",
            "fax_number": "541-923-8733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "774 SW RIMROCK WAY",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561941",
            "telephone_number": "541-923-7633",
            "fax_number": "541-923-8733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOMBE",
        "first_name": "KEVIN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-16",
        "last_updated": "2008-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D6510C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.