NPIMap

Organization Active NPI

Raelyn N Sutton DMD PC

  • Dentist
  • Grants Pass, OR
National Provider Identifier
1811155674
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4986 Issued in OR
Legal business name
RAELYN N SUTTON DMD PC
Practice address
828 NE a St
Grants Pass, OR 97526
Phone
(541) 476-9792
Fax
(541) 955-4512
NPI assigned
May 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Authorized official

Name
Dr. Raelyn Nylund Sutton, DMD
Title
President
Phone
(541) 476-9792

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 4986 OR Primary

Addresses

Primary practice location

828 NE a St
Grants Pass, OR 97526

Mailing address

828 NE a St
Grants Pass, OR 97526
Phone (541) 476-9792

National Provider Directory

National Provider Directory

Locations

828 NE A St
Grants Pass, OR 97526
Phone (541) 476-9792

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1811155674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 NE A ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "97526",
            "telephone_number": "541-476-9792",
            "fax_number": "541-955-4512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 NE A ST",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "97526",
            "telephone_number": "541-476-9792",
            "fax_number": "541-955-4512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAELYN N SUTTON DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-29",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "SUTTON",
        "authorized_official_first_name": "RAELYN",
        "authorized_official_middle_name": "NYLUND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-476-9792",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OR",
            "license": "4986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.