Keith Fusao Ogawa, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D6945 Issued in OR

Practice address

217 W. Main St.
Eagle Point, OR 97524

Phone

(541) 826-2525

Fax

(541) 826-2876

NPI assigned

Oct 21, 2008

Last updated

Oct 21, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eagle Point Dental Group,P.C.

  • Dentist
  • Eagle Point, OR
  • NPI 1780759985
  NPD (past) Authorized official

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224547200000",
    "number": "1871745901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 236",
            "address_2": "217 W. MAIN ST.",
            "city": "EAGLE POINT",
            "state": "OR",
            "postal_code": "97524",
            "telephone_number": "541-826-2525",
            "fax_number": "541-826-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 W. MAIN ST.",
            "city": "EAGLE POINT",
            "state": "OR",
            "postal_code": "97524",
            "telephone_number": "541-826-2525",
            "fax_number": "541-826-2876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGAWA",
        "first_name": "KEITH",
        "middle_name": "FUSAO",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-21",
        "last_updated": "2008-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D6945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Meyers, AU.D.
• Carla P Morey, PA
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• Kai NG
• Occupational Therapy Consulting Services, LLC
• Nathan Olson, LCSW, QMHP, CADC III
• Tiana Lorene Olson, RDH
• Michelle Paquette, MA
• Megan Peters, LMT
• Alexander Gregory O'Neal Petersen, DMD

• Dentist in Eagle Point, OR
• Providers in Eagle Point, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2008; 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.