NPIMap

Organization Active NPI

Benton County

Doing business as Benton County Health Services

  • Dental Clinic/Center
  • Corvallis, OR
National Provider Identifier
1861719015
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
BENTON COUNTY
Doing business as
Benton County Health Services
Benton Dental
Practice address
530 NW 27TH St
Corvallis, OR 97330-5223
Phone
(541) 766-0123
Fax
(541) 766-6186
NPI assigned
Apr 28, 2010
Last updated
May 1, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
BENTON COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Authorized official

Name
Lacey Mollel
Title
Health Center Director
Phone
(541) 766-6835

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

530 NW 27TH St
Corvallis, OR 97330-5223

Mailing address

PO Box 579
Corvallis, OR 97339-0579
Phone (541) 766-6835

Other identifiers 1

IdentifierTypeStateIssuer
227701MedicaidOR

Other names 2

  • Benton County Health Services Doing business as
  • Benton Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Benton County13 organizations share this tax ID, including this one
Part of
Benton County

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1861719015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 579",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973390579",
            "telephone_number": "541-766-6835",
            "fax_number": "541-766-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NW 27TH ST",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973305223",
            "telephone_number": "541-766-0123",
            "fax_number": "541-766-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENTON COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BENTON COUNTY",
        "enumeration_date": "2010-04-28",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "MOLLEL",
        "authorized_official_first_name": "LACEY",
        "authorized_official_title_or_position": "HEALTH CENTER DIRECTOR",
        "authorized_official_telephone_number": "541-766-6835"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227701",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Benton County Health Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Benton Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; 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.