Cornelius Tendercare Dental PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

9419 Issued in OR

Legal business name

CORNELIUS TENDERCARE DENTAL PC

Practice address

1890 Baseline St
Cornelius, OR 97113-8208

Phone

(503) 357-0004

Fax

(503) 359-8856

NPI assigned

Mar 17, 2014

Last updated

Mar 17, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Justin R Marostica, D.M.D.

Title

President

Phone

(503) 858-0741

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1395014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395014400000",
    "number": "1922424738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 BASELINE ST",
            "city": "CORNELIUS",
            "state": "OR",
            "postal_code": "971138208",
            "telephone_number": "503-357-0004",
            "fax_number": "503-359-8856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 BASELINE ST",
            "city": "CORNELIUS",
            "state": "OR",
            "postal_code": "971138208",
            "telephone_number": "503-357-0004",
            "fax_number": "503-359-8856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNELIUS TENDERCARE DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-17",
        "last_updated": "2014-03-17",
        "status": "A",
        "authorized_official_last_name": "MAROSTICA",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-858-0741",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OR",
            "license": "9419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Chun
• John Matthew Chung, RPH
• City of Cornelius
• Darin Closson, O.D.
• William Coldwell
• Savannah Correll, PHARMD
• Magdalena Cortez
• Genesis Cruz
• Gabriel Debenedictis
• Stephanie M Debenedictis

• Dental Clinic/Center in Cornelius, OR
• Providers in Cornelius, OR by specialty
• Dental Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.