Willow Dental Group LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

WILLOW DENTAL GROUP LLC

Doing business as

Cedar Dental

Practice address

20140 McLoughlin Blvd
Gladstone, OR 97027-2604

Phone

(971) 707-0117

NPI assigned

Feb 16, 2024

Last updated

Jun 24, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Benjamin James, DDS

Title

Owner

Phone

(541) 666-6091

Specialties & licenses 1

Addresses

Other names 1

• Cedar Dental Doing business as

Locations

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

{
    "created_epoch": "1708041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719187200000",
    "number": "1821853193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20140 MCLOUGHLIN BLVD",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970272604",
            "telephone_number": "971-404-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20140 MCLOUGHLIN BLVD",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970272604",
            "telephone_number": "971-707-0117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8568 SW Apple Way",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972251772",
            "country_code": "US",
            "telephone_number": "503-292-6773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WILLOW DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-666-6091",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedar Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Gladstone, OR
• Providers in Gladstone, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.