Woodburn Cosmetic & Family Dentistry P.C.

Primary specialty

DentistTaxonomy code 122300000X

License

D6259 Issued in OR

Legal business name

WOODBURN COSMETIC & FAMILY DENTISTRY P.C.

Practice address

1018 N. Boones Ferry Rd.
Woodburn, OR 97071

Phone

(503) 981-1841

Fax

(503) 981-7334

NPI assigned

Mar 18, 2010

Organization subpart

No

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

Authorized official

Name

Steven Blakley, D.M.D.

Title

Owner

Phone

(503) 981-1841

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1268870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268870400000",
    "number": "1801110994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 N. BOONES FERRY RD.",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "97071",
            "telephone_number": "503-981-1841",
            "fax_number": "503-981-7334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 N. BOONES FERRY RD.",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "97071",
            "telephone_number": "503-981-1841",
            "fax_number": "503-981-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODBURN COSMETIC & FAMILY DENTISTRY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-18",
        "last_updated": "2010-03-18",
        "status": "A",
        "authorized_official_last_name": "BLAKLEY",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-981-1841",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OR",
            "license": "D6259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Woodburn, OR
• Providers in Woodburn, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2010; 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.