Individual provider Active NPI

David C Zandberg, R.PH.

  • Pharmacist
  • Dallas, OR
National Provider Identifier
1891033247
Registry record updated Jan 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH-0010856 Issued in OR
Practice address
138 W Ellendale Ave
Dallas, OR 97338-1408
Phone
(503) 831-6006
Fax
(503) 831-6008
NPI assigned
Jan 18, 2013
Last updated
Jan 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2013

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 17050 NV
Pharmacist 183500000X 6080043-1701 UT
Pharmacist 183500000X 17476 NJ
Pharmacist 183500000X PH00067430 WA
Pharmacist 183500000X S015790 AZ
Pharmacist 183500000X RPH-0010856 OR Primary
Pharmacist 183500000X 44705 CA

Addresses

Primary practice location

138 W Ellendale Ave
Dallas, OR 97338-1408

Mailing address

138 W Ellendale Ave
Dallas, OR 97338-1408
Phone (503) 831-6006

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
S015790AZMDPharmacist
17476NJMDPharmacist
RPH-0010856ORMDPharmacist
6080043-1701UTMDPharmacist
PH00067430WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Safeway Inc Past Accepting new patients
Safeway Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1358467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358553600000",
    "number": "1891033247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 W ELLENDALE AVE",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973381408",
            "telephone_number": "503-831-6006",
            "fax_number": "503-831-6008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 W ELLENDALE AVE",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973381408",
            "telephone_number": "503-831-6006",
            "fax_number": "503-831-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANDBERG",
        "first_name": "DAVID",
        "middle_name": "C",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-18",
        "last_updated": "2013-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "17050",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "6080043-1701",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "17476",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00067430",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S015790",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0010856",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "44705",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2013; 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.