Individual provider Active NPI

Matthew Bahen, DMD

  • General Practice Dentistry
  • Creswell, OR
National Provider Identifier
1679664148
Registry record updated May 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D8799 Issued in OR
Practice address
195 Melton Rd.
Creswell, OR 97426
Phone
(541) 895-3000
Fax
(541) 895-5801
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2009

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 D8799 OR Primary

Addresses

Primary practice location

195 Melton Rd.
Creswell, OR 97426

Mailing address

195 Melton Rd.
Creswell, OR 97426
Phone (541) 895-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D8799ORMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241395200000",
    "number": "1679664148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 MELTON RD.",
            "city": "CRESWELL",
            "state": "OR",
            "postal_code": "97426",
            "telephone_number": "541-895-3000",
            "fax_number": "541-895-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 MELTON RD.",
            "city": "CRESWELL",
            "state": "OR",
            "postal_code": "97426",
            "telephone_number": "541-895-3000",
            "fax_number": "541-895-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHEN",
        "first_name": "MATTHEW",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2009-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D8799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Creswell, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.