Donald Randol, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D7054 Issued in OR

Practice address

150 NE Kenneth Ford Dr
Roseburg, OR 97470-1042

Phone

(541) 672-9596

Fax

(541) 677-9216

NPI assigned

Dec 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: donald.randol.1@17792.direct.athenahealth.com

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1689742298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 NE KENNETH FORD DR",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701042",
            "telephone_number": "541-672-9596",
            "fax_number": "541-677-9216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 NE KENNETH FORD DR",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974701042",
            "telephone_number": "541-672-9596",
            "fax_number": "541-677-9216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOL",
        "first_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Ramirez
• Mark Allan Ramirez, M.D.
• Maria Louisa Ramos, PSS
• Randall B Loch MD PC
• Alanson Marshall Randol, D.D.S.
• Michael Randolph
• Jo Dena Rankin-Searles, QMHA
• Elle Flury Rappe, LMSW
• Jawairiya Rasool, MBBS, MPH, MBA
• Debra J Raumakita, APNP

• General Practice Dentistry in Roseburg, OR
• Providers in Roseburg, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.