Springfield Kids Dentist LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D8929 Issued in OR

Legal business name

SPRINGFIELD KIDS DENTIST LLC

Practice address

5895 Main St
Springfield, OR 97478-6961

Phone

(541) 654-4996

Fax

(541) 505-8463

NPI assigned

Nov 26, 2017

Organization subpart

No

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

Authorized official

Name

Femina Jane Bedolla

Title

Operations Officer

Phone

(541) 844-3113

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

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

• Bradley Blake Field, D.D.S.

  • Pediatric Dentistry
  • Bend, OR
  • NPI 1154645471
  NPD (past)
• Alan Roy Lapratt, DMD

  • Pediatric Dentistry
  • York, PA
  • NPI 1578851804
  NPD (past)

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

{
    "created_epoch": "1511654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511654400000",
    "number": "1831603018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5895 MAIN ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974786961",
            "telephone_number": "541-654-4996",
            "fax_number": "541-505-8463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5895 MAIN ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974786961",
            "telephone_number": "541-654-4996",
            "fax_number": "541-505-8463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGFIELD KIDS DENTIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-26",
        "last_updated": "2017-11-26",
        "status": "A",
        "authorized_official_last_name": "BEDOLLA",
        "authorized_official_first_name": "FEMINA",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "OPERATIONS OFFICER",
        "authorized_official_telephone_number": "541-844-3113"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OR",
            "license": "D8929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "279295",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE INSURANCE",
            "identifier": "1528268281",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Spine Center of Eugene, Inc
• Kellie Marissa Sprangel, MD
• Spring Valley Limited Partnership
• Springfield Dental Partners LLC
• Springfield Holistic Health Center, LLC
• Springfield of Olympus, LLC
• Springfield Or Anesthesia Associates LLC
• Springfield Treatment Center
• Stephanie Spurgat
• Brian St. George, MD

• Pediatric Dentistry in Springfield, OR
• Providers in Springfield, OR by specialty
• Pediatric Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2017; 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.