Acorn Dentistry for Kids - Lebanon, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D9577 Issued in OR

Legal business name

ACORN DENTISTRY FOR KIDS - LEBANON, LLC

Practice address

1780 S Main St
Lebanon, OR 97355-3139

Phone

(503) 874-4560

Fax

(503) 874-4562

NPI assigned

Dec 6, 2016

Organization subpart

Yes

Parent organization

ACORN DENTISTRY FOR KIDS, LLCAs reported in NPPES

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

Authorized official

Name

Tim Richardson, DDS

Title

Owner

Phone

(360) 852-0809

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1480982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480982400000",
    "number": "1831633122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1780 S MAIN ST",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973553139",
            "telephone_number": "503-874-4560",
            "fax_number": "503-874-4562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 S MAIN ST",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973553139",
            "telephone_number": "503-874-4560",
            "fax_number": "503-874-4562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACORN DENTISTRY FOR KIDS - LEBANON, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ACORN DENTISTRY FOR KIDS, LLC",
        "enumeration_date": "2016-12-06",
        "last_updated": "2016-12-06",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-852-0809",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": "D9577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marjo Aardema, LMT
• Adam Kirkpatrick, DDS Family and Cosmetic Dentistry, LLC
• Advanced Imaging LLC
• Advanced Imaging, LLC
• Natalie A Aerni
• Shelli A Alinari-Beebe, PHD

• Dental Clinic/Center in Lebanon, OR
• Providers in Lebanon, OR by specialty
• Dental Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.

Verify at the official NPI Registry.