Northwest Dental Associates -Medford LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D8673 Issued in OR

Legal business name

NORTHWEST DENTAL ASSOCIATES -MEDFORD LLC

Practice address

3551 E Barnett Rd
Suite 101
Medford, OR 97504-7037

Phone

(541) 779-3993

Fax

(541) 779-3382

NPI assigned

Nov 17, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Deborah Hart

Title

Office Manager

Phone

(541) 779-3993

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1479340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479340800000",
    "number": "1851833131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 E BARNETT RD",
            "address_2": "SUITE 101",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047037",
            "telephone_number": "541-779-3993",
            "fax_number": "541-779-3382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 E BARNETT RD",
            "address_2": "SUITE 101",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047037",
            "telephone_number": "541-779-3993",
            "fax_number": "541-779-3382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST DENTAL ASSOCIATES -MEDFORD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-17",
        "last_updated": "2016-11-17",
        "status": "A",
        "authorized_official_last_name": "HART",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "541-779-3993",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D8673",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D8768",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "1770660912",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "1962623603",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Scott Normandin
• Tabitha Norris, RPH
• Sarah Jean North, L.M.T.
• Northland Hearing Centers, Inc. (Pacific Coast Hearing Center)
• Northridge Senior Living, LLC
• Northwest Diagnostic Services
• Northwest Life Chiropractic
• Northwest Medical, LLC.
• Northwest Pain Management Inc (Intractable Pain Centers)
• Northwest Pain Management PC (Intractable Pain Centers)

• General Practice Dentistry in Medford, OR
• Providers in Medford, 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 Nov 17, 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.