NPIMap

Organization Active NPI

Pediatric Dental Associates of Salem

  • Pediatric Dentistry
  • Salem, OR
National Provider Identifier
1851041123
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
PEDIATRIC DENTAL ASSOCIATES OF SALEM
Practice address
2020 Commercial St SE
Salem, OR 97302-5208
Phone
(503) 364-7545
NPI assigned
Mar 28, 2022
Organization subpart
Yes
Parent organization
F & G INVESTMENTS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 28, 2022

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

Authorized official

Name
Ms. Madison Pate
Title
Business Manager
Phone
(541) 928-1509

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

2020 Commercial St SE
Salem, OR 97302-5208

Mailing address

2020 Commercial St SE
Salem, OR 97302-5208

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address madison@pediatricdentistoregon.com Direct F & G Investments, LLC

National Provider Directory

National Provider Directory
Part of
F G Investments LLC

Locations

155 Hickory St NW
Ste A
Albany, OR 97321
Phone (541) 928-1509

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648425600000",
    "number": "1851041123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 COMMERCIAL ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973025208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 COMMERCIAL ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973025208",
            "telephone_number": "503-364-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL ASSOCIATES OF SALEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "F & G INVESTMENTS, LLC",
        "enumeration_date": "2022-03-28",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-24",
        "status": "A",
        "authorized_official_last_name": "PATE",
        "authorized_official_first_name": "MADISON",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "541-928-1509",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "madison@pediatricdentistoregon.com",
            "affiliation": "Y",
            "endpointDescription": "professional encrypted email for business manager",
            "affiliationName": "F & G Investments, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "155 NW Hickory St",
            "address_2": "Suite A",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973211724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; 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.