Mountain Valley Dental Group P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D8800 Issued in OR

Legal business name

MOUNTAIN VALLEY DENTAL GROUP P.C.

Practice address

3980 Midway Dr
Baker City, OR 97814-1453

Phone

(541) 523-6311

Fax

(541) 523-6312

NPI assigned

Jul 16, 2009

Organization subpart

No

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

Authorized official

Name

Kirsten Harrison

Title

Business Manager

Phone

(541) 567-8414

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• G. Adam Fulton, DDS

  • Dentist
  • Hermiston, OR
  • NPI 1932360807
  NPD (past)
• Daniel Hayden, DDS

  • General Practice Dentistry
  • Hermiston, OR
  • NPI 1437160785
  NPD (past)
• Matthew J Hayden, DDS

  • General Practice Dentistry
  • Hermiston, OR
  • NPI 1174506000
  NPD (past)

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247702400000",
    "number": "1639309271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 W ELM AVE STE 240",
            "city": "HERMISTON",
            "state": "OR",
            "postal_code": "978382714",
            "telephone_number": "541-567-8414",
            "fax_number": "541-567-8422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3980 MIDWAY DR",
            "city": "BAKER CITY",
            "state": "OR",
            "postal_code": "978141453",
            "telephone_number": "541-523-6311",
            "fax_number": "541-523-6312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VALLEY DENTAL GROUP P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-16",
        "last_updated": "2009-07-16",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "KIRSTEN",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "541-567-8414"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D8800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "241313",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Minor, OTR/L
• Logan Thompson Mitchell, O.D.
• Vince Phillip Mitchell
• Lois Ann Moore, M.D.
• Mountain Air Functional Medicine
• Mountain Valley Mental Health Programs, Inc.
• Gaylene Moyers, CCMA
• Karly Munroe, PT, DPT
• Paul L Munson
• Stephenie Jo Murdock

• General Practice Dentistry in Baker City, OR
• Providers in Baker City, 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 16, 2009; 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.