NPIMap

Organization Active NPI

Dental Professionals of Oregon, P.C.

Doing business as V2 Dentistry

  • General Practice Dentistry
  • Keizer, OR
National Provider Identifier
1902567563
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL PROFESSIONALS OF OREGON, P.C.
Doing business as
V2 Dentistry
Practice address
4575 River Rd N
Keizer, OR 97303-4645
Phone
(503) 393-2651
NPI assigned
Jan 5, 2022
Organization subpart
Yes
Parent organization
HEARTLAND DENTALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Authorized official

Name
Hillary Thull
Title
Credentialing Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

4575 River Rd N
Keizer, OR 97303-4645

Mailing address

4575 River Rd N
Keizer, OR 97303-4645

Other names 1

  • V2 Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Professionals of Oregon PC11 organizations share this tax ID, including this one
Part of
Dental Professionals of Oregon PC

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641340800000",
    "number": "1902567563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4575 RIVER RD N",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4575 RIVER RD N",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034645",
            "telephone_number": "503-393-2651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF OREGON, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEARTLAND DENTAL",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-04",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "V2 Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Keizer, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.