Active NPI
Cliff P Robertson, LD
- Denturist
- Ontario, OR
National Provider Identifier
1861905010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Denturist
- License
- 10170823
- Practice address
- 975 SW 1St Ave
Ontario, OR 97914-2112 - Phone
- (541) 889-3750
- NPI assigned
- Nov 9, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Denturist | 122400000X | 10170823 | OR | Primary |
Addresses
Primary practice location
975 SW 1St Ave
Ontario, OR 97914-2112
Mailing address
975 SW 1St Ave
Ontario, OR 97914-2112
Phone (541) 889-3750
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10170823 | OR | MD | Denturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1861905010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "975 SW 1ST AVE",
"city": "ONTARIO",
"state": "OR",
"postal_code": "979142112",
"telephone_number": "541-889-3750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "975 SW 1ST AVE",
"city": "ONTARIO",
"state": "OR",
"postal_code": "979142112",
"telephone_number": "541-889-3750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "CLIFF",
"middle_name": "P",
"credential": "LD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-11-09",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "122400000X",
"taxonomy_group": "",
"desc": "Denturist",
"state": "OR",
"license": "10170823",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ontario, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.