Individual provider Active NPI

Jeffrey Guelinas, DDS

  • Dentist
  • Chiloquin, OR
National Provider Identifier
1902087349
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D11418 Issued in OR
Practice address
330 S Chiloquin Blvd
Chiloquin, OR 97624-6747
Phone
(541) 882-1487
Fax
(541) 783-2028
NPI assigned
Nov 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7421 AZ
Dentist 122300000X D11418 OR Primary

Addresses

Primary practice location

330 S Chiloquin Blvd
Chiloquin, OR 97624-6747

Mailing address

330 S Chiloquin Blvd
Chiloquin, OR 97624-6747
Phone (541) 882-1487

Other practice location 1

1245 Fulton Ave
Coos Bay, OR 97420-2895
Phone (541) 888-6433

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

LicenseStateTypeSpecialty
7421AZMDChiropractor
D11418ORMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Confederated Tribes of Coos, Lower Umpqua, & Siuslaw Indians CurrentSince Jun 9, 2024 Accepting new patients
Dental One, Inc. Dentist Past Accepting new patients
Confederated Tribes of Coos, Lower Umpqua & Siuslaw Indians PastSince Apr 1, 2021 Accepting new patients

Locations

1245 Fulton Ave
Coos Bay, OR 97420
Phone (541) 888-6433

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1902087349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 S CHILOQUIN BLVD",
            "city": "CHILOQUIN",
            "state": "OR",
            "postal_code": "976246747",
            "telephone_number": "541-882-1487",
            "fax_number": "541-783-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 S CHILOQUIN BLVD",
            "city": "CHILOQUIN",
            "state": "OR",
            "postal_code": "976246747",
            "telephone_number": "541-882-1487",
            "fax_number": "541-783-2028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1245 Fulton Ave",
            "address_purpose": "LOCATION",
            "city": "Coos Bay",
            "state": "OR",
            "postal_code": "974202895",
            "country_code": "US",
            "telephone_number": "541-888-6433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUELINAS",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-14",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "7421",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D11418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chiloquin, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; 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.