NPIMap

Organization Active NPI

Acorn Dentistry for Kids - Corvallis, LLC

  • Dental Clinic/Center
  • Corvallis, OR
National Provider Identifier
1669960019
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D9577 Issued in OR
Legal business name
ACORN DENTISTRY FOR KIDS - CORVALLIS, LLC
Practice address
1731 NW Kings Blvd
Corvallis, OR 97330-1905
Phone
(503) 874-4560
Fax
(503) 874-4562
NPI assigned
May 1, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Authorized official

Name
Timothy Richardson, DDSNPI 1184855967
Title
Owner/Dentist
Phone
(503) 874-4560

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 D9577 OR Primary

Addresses

Primary practice location

1731 NW Kings Blvd
Corvallis, OR 97330-1905

Mailing address

411 N Water St
Silverton, OR 97381-1625
Phone (503) 874-4560

Other names 1

  • Acorn Dentistry For Kids - Corvallis Doing business as

National Provider Directory

National Provider Directory

Locations

1731 NW Kings Blvd
Corvallis, OR 97330
Phone (541) 705-2470

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": "1525132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525132800000",
    "number": "1669960019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 N WATER ST",
            "city": "SILVERTON",
            "state": "OR",
            "postal_code": "973811625",
            "telephone_number": "503-874-4560",
            "fax_number": "503-874-4562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 NW KINGS BLVD",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973301905",
            "telephone_number": "503-874-4560",
            "fax_number": "503-874-4562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACORN DENTISTRY FOR KIDS - CORVALLIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-01",
        "last_updated": "2018-05-01",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "503-874-4560",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": "D9577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Acorn Dentistry For Kids - Corvallis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Acorn Dentistry For Kids - Corvallis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; 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.