Coral Esther Stromg Creighton, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D11852 Issued in OR

Practice address

1740 W 17TH Ave
Eugene, OR 97402-3619

Phone

(458) 228-3271

NPI assigned

Jul 19, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Coral Esther Strom Former name

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1912687450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 GOODPASTURE LOOP APT P262",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974011495",
            "telephone_number": "406-697-2846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W 17TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974023619",
            "telephone_number": "458-228-3271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREIGHTON",
        "first_name": "CORAL",
        "middle_name": "ESTHER STROMG",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D11852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORAL",
            "last_name": "STROM",
            "middle_name": "ESTHER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dentist in Eugene, OR
• Providers in Eugene, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.