Oregon Pip Dental Group, PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D7666 Issued in OR

Legal business name

OREGON PIP DENTAL GROUP, PC

Practice address

419 State St Ste 4
Hood River, OR 97031-2075

Phone

(541) 387-8688

Fax

(541) 387-6785

NPI assigned

Sep 16, 2009

Organization subpart

No

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

Authorized official

Name

Mellissa Renner

Title

Regional Operation Manager

Phone

(541) 571-7145

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• J. Kyle House, DDS, PC Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jerald Kyle House, D.D.S.

  • Pediatric Dentistry
  • Hood River, OR
  • NPI 1710989827
  NPD (past)

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570406400000",
    "number": "1730412149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 STATE ST STE 4",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970312075",
            "telephone_number": "541-387-8688",
            "fax_number": "541-387-6785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 STATE ST STE 4",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970312075",
            "telephone_number": "541-387-8688",
            "fax_number": "541-387-6785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON PIP DENTAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-16",
        "last_updated": "2019-10-07",
        "status": "A",
        "authorized_official_last_name": "RENNER",
        "authorized_official_first_name": "MELLISSA",
        "authorized_official_title_or_position": "REGIONAL OPERATION MANAGER",
        "authorized_official_telephone_number": "541-571-7145"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OR",
            "license": "D7666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5036470",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "J. Kyle House, DDS, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "J. Kyle House, DDS, PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• One Community Health
• Onyx Counseling Consulting & Supervision, LLC.
• Opportunity Connections, Inc.
• Oregon Center for Optimal Health
• Oregon Health Sciences University Department of Ophthalmology
• Maryfer Montserrat Ortiz Lopez
• Jessica R Ortiz, FNP-BC
• Dylan Osborne
• Leandra M Paasch, BA, QMHA
• Lisa Rene Pacheco, LMT

• Pediatric Dentistry in Hood River, OR
• Providers in Hood River, OR by specialty
• Pediatric Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; 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.