Statewide Dental Service, PC

Primary specialty

DentistTaxonomy code 122300000X

License

D6958 Issued in OR

Legal business name

STATEWIDE DENTAL SERVICE, PC

Practice address

498 Harlow Rd Ste 3
Springfield, OR 97477-1339

Phone

(541) 393-7000

NPI assigned

May 10, 2010

Organization subpart

No

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

Authorized official

Name

Cedric Ross Hayden, DDS

Title

President

Phone

(541) 393-7000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273449600000",
    "number": "1831417245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "498 HARLOW RD STE 3",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974771339",
            "telephone_number": "541-393-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "498 HARLOW RD STE 3",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974771339",
            "telephone_number": "541-393-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEWIDE DENTAL SERVICE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-10",
        "last_updated": "2010-05-10",
        "status": "A",
        "authorized_official_last_name": "HAYDEN",
        "authorized_official_first_name": "CEDRIC",
        "authorized_official_middle_name": "ROSS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-393-7000",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OR",
            "license": "D6958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Leone Stanton
• Beth Stanton, RPH
• Charles J Stanton, M.D.
• Mark Fielding Stapleton, DMD
• Barbara Jane Starr
• Michelle Marie Stecher, FNP
• Anthony Daniel Steier, PA-C
• Beata Esther Stein, CNM
• Asha Stephen, PH.D.
• Abigail Esther Stephens, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.