Keizer Family Dental Care

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D7121 Issued in OR

Legal business name

KEIZER FAMILY DENTAL CARE

Practice address

4600 River Rd N
Keizer, OR 97303-4648

Phone

(503) 393-2264

Fax

(503) 393-2324

NPI assigned

May 7, 2012

Last updated

May 7, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Marc T. Iwahiro, DMDNPI 1629103437

Title

Dentist

Phone

(503) 393-2264

Specialties & licenses 1

Addresses

Practitioners 2

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.

• Marc T. Iwahiro, DMD

  • General Practice Dentistry
  • Keizer, OR
  • NPI 1629103437
  NPD (past) Authorized official
• Junghee Jodi Pak, D.D.S

  • Dentist
  • Keizer, OR
  • NPI 1609221845
  NPD (past)

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

{
    "created_epoch": "1336348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336348800000",
    "number": "1699034082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 RIVER RD N",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034648",
            "telephone_number": "503-393-2264",
            "fax_number": "503-393-2324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 RIVER RD N",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034648",
            "telephone_number": "503-393-2264",
            "fax_number": "503-393-2324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEIZER FAMILY DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-07",
        "last_updated": "2012-05-07",
        "status": "A",
        "authorized_official_last_name": "IWAHIRO",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "503-393-2264",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Demi Keitel, LPC, LCPC
• Keizer Campus Operations, LLC (Avamere Court at Keizer)
• Keizer Care Properties, LLC (Village at Keizer Ridge Assisted Living & Memory Care)
• Keizer Chiropractic Clinic PC
• Keizer Diabetes & Metabolism Clinic
• Keizer Family Physicians PC
• Keizer Hearing Aid Center
• Keizer Nursing & Rehab Center LLC
• Keizer of Cascadia, LLC
• Keizer of Olympus, LLC

• General Practice Dentistry in Keizer, OR
• Providers in Keizer, 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 May 7, 2012; 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.