Rogue Valley Dental Center LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ROGUE VALLEY DENTAL CENTER LLC

Practice address

1150 Crater Lake Ave
Suite E
Medford, OR 97504-6213

Phone

(541) 779-4517

Fax

(541) 779-4605

NPI assigned

Jul 16, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Keith Berg

Title

Owner

Phone

(541) 779-4517

Specialties & licenses 1

Addresses

Tax ID family

Rogue Valley Dental Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Rogue Valley Dental Center

  • General Practice Dentistry
  • Medford, OR
  • NPI 1760752141
  NPD tax ID

Locations

Practitioners 1

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

• Jed William Taucher, DMD

  • Dentist
  • Medford, OR
  • NPI 1619231271
  NPD (past)

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405468800000",
    "number": "1871900365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 CRATER LAKE AVE",
            "address_2": "SUITE E",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046213",
            "telephone_number": "541-779-4517",
            "fax_number": "541-779-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 CRATER LAKE AVE",
            "address_2": "SUITE E",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046213",
            "telephone_number": "541-779-4517",
            "fax_number": "541-779-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGUE VALLEY DENTAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-16",
        "last_updated": "2014-07-16",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-779-4517",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rogue Retreat
• Rogue School of Phlebotomy LLC
• Rogue Therapy
• Rogue Valley Childrens Physicians
• Rogue Valley Dental Center
• Rogue Valley Doulas, LLC
• Rogue Valley Family Dentistry Medford LLC
• Rogue Valley Family Practice, PC
• Rogue Valley Foot Clinic P.C.
• Rogue Valley Health & Wellness LLC

• 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 Jul 16, 2014; 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.