Active NPI
Nathan M Tanner, DMD
- General Practice Dentistry
- Jacksonville, OR
National Provider Identifier
1821289984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D8947
- Practice address
- 725 N 5TH St Ste 101
Jacksonville, OR 97530 - Phone
- (541) 862-1848
- Fax
- (541) 474-5005
- NPI assigned
- Aug 5, 2007
- Last updated
- Mar 29, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D8947 | OR | Primary |
Addresses
Primary practice location
725 N 5TH St Ste 101
Jacksonville, OR 97530
Mailing address
2288 Williams Hwy
Grants Pass, OR 97527
Phone (541) 862-1848
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D8947 | OR | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459209600000",
"number": "1821289984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2288 WILLIAMS HWY",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "97527",
"telephone_number": "541-862-1848",
"fax_number": "541-474-5005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 N 5TH ST STE 101",
"city": "JACKSONVILLE",
"state": "OR",
"postal_code": "97530",
"telephone_number": "541-862-1848",
"fax_number": "541-474-5005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANNER",
"first_name": "NATHAN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-05",
"last_updated": "2016-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "D8947",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.