Alexis Atchinson, D.D.S.
Individual provider Active NPI Dentist · Roseburg, OR
NPI 1922439876 · NPPES record last updated Dec 3, 2013
Key facts
- NPI
- 1922439876
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- D9690 (OR)
- Practice address
- 1100 NW Garden Valley Blvd
Roseburg, OR 97471-1923 - Phone
- (541) 673-7437
- NPI assigned
- Dec 3, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D9690 | OR | MD | Dentist |
| 31748 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alanson M. Randol DDS, P.C. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D9690 | OR | Yes |
| Dentist | 122300000X | 31748 | CA |
Addresses
Primary practice location
1100 NW Garden Valley Blvd
Roseburg, OR 97471-1923
Mailing address
1100 NW Garden Valley Blvd
Roseburg, OR 97471-1923
Phone (541) 673-7437
Other providers in Roseburg, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.