NPIMap

Organization Active NPI

Cornerstone Dentistry, LLC

  • General Practice Dentistry
  • Island City, OR
National Provider Identifier
1750838694
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D7796 Issued in OR
Legal business name
CORNERSTONE DENTISTRY, LLC
Practice address
10100 N McAlister Rd
Island City, OR 97850-8701
Phone
(541) 963-6445
Fax
(541) 963-9012
NPI assigned
Sep 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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

Authorized official

Name
Dr. Brian L Kruse, DMDNPI 1851406748
Title
Owner/Sole Proprietor
Phone
(541) 963-6445

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D7796 OR Primary

Addresses

Primary practice location

10100 N McAlister Rd
Island City, OR 97850-8701

Mailing address

10100 N McAlister Rd
Island City, OR 97850-8701
Phone (541) 963-6445

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473292800000",
    "number": "1750838694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10100 N MCALISTER RD",
            "city": "ISLAND CITY",
            "state": "OR",
            "postal_code": "978508701",
            "telephone_number": "541-963-6445",
            "fax_number": "541-963-9012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10100 N MCALISTER RD",
            "city": "ISLAND CITY",
            "state": "OR",
            "postal_code": "978508701",
            "telephone_number": "541-963-6445",
            "fax_number": "541-963-9012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-08",
        "last_updated": "2016-09-08",
        "status": "A",
        "authorized_official_last_name": "KRUSE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/SOLE PROPRIETOR",
        "authorized_official_telephone_number": "541-963-6445",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D7796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Island City, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; 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.