NPIMap

Organization Active NPI

Klamath Smiles, LLC

  • Dental Clinic/Center
  • Klamath Falls, OR
National Provider Identifier
1669853487
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
KLAMATH SMILES, LLC
Practice address
2301 Mountain View Blvd Ste D
Klamath Falls, OR 97601-1137
Phone
(541) 882-9039
Fax
(866) 437-2057
NPI assigned
Jun 17, 2015
Last updated
Apr 6, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Authorized official

Name
Mark C Davis, DDSNPI 1184742579
Title
Owner
Phone
(541) 882-9039

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

2301 Mountain View Blvd Ste D
Klamath Falls, OR 97601-1137

Mailing address

2301 Mountain View Blvd Ste D
Klamath Falls, OR 97601-1137
Phone (541) 882-9039

National Provider Directory

National Provider Directory

Locations

2301 Mountain View Blvd
Ste D
Klamath Falls, OR 97601
Phone (541) 882-9039

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491436800000",
    "number": "1669853487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 MOUNTAIN VIEW BLVD STE D",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011137",
            "telephone_number": "541-882-9039",
            "fax_number": "866-437-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 MOUNTAIN VIEW BLVD STE D",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976011137",
            "telephone_number": "541-882-9039",
            "fax_number": "866-437-2057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLAMATH SMILES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-17",
        "last_updated": "2017-04-06",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-882-9039",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.