NPIMap

Organization Active NPI

Two Thirty Dental, LLC

  • General Practice Dentistry
  • Roseburg, OR
National Provider Identifier
1649680281
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9826 Issued in OR
Legal business name
TWO THIRTY DENTAL, LLC
Practice address
1168 NW Garden Valley Blvd
Roseburg, OR 97471-1923
Phone
(541) 378-3210
NPI assigned
May 5, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2014

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

Authorized official

Name
Mrs. Amy Marko
Title
Insurance Operations VP
Phone
(315) 454-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 9826 OR Primary

Addresses

Primary practice location

1168 NW Garden Valley Blvd
Roseburg, OR 97471-1923

Mailing address

1168 NW Garden Valley Blvd
Roseburg, OR 97471-1923
Phone (541) 378-3210

Other names 1

  • Aspen Dental Doing business as

National Provider Directory

National Provider Directory

Locations

1168 NW Garden Valley Blvd
Roseburg, OR 97471
Phone (541) 375-0978

Practitioners & affiliated clinicians

Practitioners 6

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": "1399248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399248000000",
    "number": "1649680281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1168 NW GARDEN VALLEY BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711923",
            "telephone_number": "541-378-3210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1168 NW GARDEN VALLEY BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711923",
            "telephone_number": "541-378-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWO THIRTY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-05",
        "last_updated": "2014-05-05",
        "status": "A",
        "authorized_official_last_name": "MARKO",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "INSURANCE OPERATIONS VP",
        "authorized_official_telephone_number": "315-454-6000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "9826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspen Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; 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.