Oregon Community Dental Care

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

OREGON COMMUNITY DENTAL CARE

Practice address

671 SW Main St
Winston, OR 97496-6571

Phone

(888) 468-0022

Fax

(541) 504-3907

NPI assigned

Mar 16, 2012

Last updated

Mar 16, 2012By 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

R. Mike Shirtcliff, DMD

Title

President/Ceo

Phone

(888) 468-0022

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1331856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331856000000",
    "number": "1629343140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 SW UMATILLA AVE STE 200",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977567039",
            "telephone_number": "888-468-0022",
            "fax_number": "541-504-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "671 SW MAIN ST",
            "city": "WINSTON",
            "state": "OR",
            "postal_code": "974966571",
            "telephone_number": "888-468-0022",
            "fax_number": "541-504-3907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON COMMUNITY DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-16",
        "last_updated": "2012-03-16",
        "status": "A",
        "authorized_official_last_name": "SHIRTCLIFF",
        "authorized_official_first_name": "R. MIKE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "888-468-0022",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay Nicole Merritt, PHD, LCSW
• Skyler Scott Meyer, NP
• Orlando Antonio Morales Guerra, CSFA,CSA,CST
• Joshua Myers, DDS
• Sara Ann Myers, PHARMD
• Emily Ann Robertson, RDH
• Ronald F. Tribble, DMD, PC
• Jonathan Forrest Russell, PA
• Second Wind Mental Health Clinic
• Michael Wayne Smith- Fernandez, LCSW

• General Practice Dentistry in Winston, OR
• Providers in Winston, 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 Mar 16, 2012; 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.