Individual provider Active NPI

Robert Anthony Bass, DMD

  • General Practice Dentistry
  • Bend, OR
National Provider Identifier
1659417327
Registry record updated Sep 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D5938 Issued in OR
Practice address
2381 NE Conners Ave
Bend, OR 97701-6068
Phone
(541) 678-6262
Fax
(541) 516-4039
NPI assigned
Jan 30, 2007
Last updated
Sep 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2019

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 D5938 OR Primary

Addresses

Primary practice location

2381 NE Conners Ave
Bend, OR 97701-6068

Mailing address

PO Box 11470
Eugene, OR 97440-3670
Phone (999) 368-0022

Other practice location 1

508 Upland Street
Kenai, AK 99611
Phone (907) 335-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20160315002328 TX Order and Referring Only - DentistPractitioner - Dentist 0446556575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Dental Group, PC General Practice PastSince Sep 29, 2019 Accepting new patients
Advantage Dental Group, PC General Practice PastSince Sep 29, 2019 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1659417327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11470",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974403670",
            "telephone_number": "999-368-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2381 NE CONNERS AVE",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016068",
            "telephone_number": "541-678-6262",
            "fax_number": "541-516-4039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "508 Upland Street",
            "address_purpose": "LOCATION",
            "city": "Kenai",
            "state": "AK",
            "postal_code": "99611",
            "country_code": "US",
            "telephone_number": "907-335-7500",
            "fax_number": "888-491-3360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASS",
        "first_name": "ROBERT",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D5938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.