Individual provider Active NPI

Brian Ogle, D.M.D.

  • General Practice Dentistry
  • Newberg, OR
National Provider Identifier
1679957633
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D10303 Issued in OR
Practice address
902 Deborah Rd
Newberg, OR 97132-2001
Phone
(503) 538-3129
Fax
(503) 538-3120
NPI assigned
Jul 18, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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 D10303 OR Primary

Addresses

Primary practice location

902 Deborah Rd
Newberg, OR 97132-2001

Mailing address

902 Deborah Rd
Newberg, OR 97132-2001
Phone (503) 538-3129

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20200721004013 OR Order and Referring Only - DentistPractitioner - Dentist 8527482751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D10303ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Chehalem Dental, LLC General Practice Current Accepting new patients
Keizer Rapids Dental, LLC General Practice Current Accepting new patients
Mark E. Barnard, D.M.D., PC Past Accepting new patients

Locations

902 N Deborah Rd
Newberg, OR 97132
Phone (503) 537-8781

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1437177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524096000000",
    "number": "1679957633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 DEBORAH RD",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971322001",
            "telephone_number": "503-538-3129",
            "fax_number": "503-538-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 DEBORAH RD",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971322001",
            "telephone_number": "503-538-3129",
            "fax_number": "503-538-3120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGLE",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-18",
        "last_updated": "2018-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D10303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newberg, OR

Sources for this page

Verify at the official NPI Registry.