NPIMap

Organization Active NPI

Advantage Dental Clinics, LLC

  • General Practice Dentistry
  • Redmond, OR
National Provider Identifier
1992935357
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ADVANTAGE DENTAL CLINICS, LLC
Practice address
442 SW Umatilla Ave Ste 200
Redmond, OR 97756-7039
Phone
(866) 268-9616
Fax
(541) 504-3907
NPI assigned
Jul 20, 2009
Last updated
Sep 23, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

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

Authorized official

Name
Dr. R Mike Shirtcliff, DMD
Title
President/Ceo/Dental Director
Phone
(866) 268-9616

Specialties & licenses 1

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

Addresses

Primary practice location

442 SW Umatilla Ave Ste 200
Redmond, OR 97756-7039

Mailing address

PO Box 490
Redmond, OR 97756-0092
Phone (866) 268-9616

National Provider Directory

National Provider Directory
Tax ID family
Advantage Dental Clinics LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1248048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316736000000",
    "number": "1992935357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977560092",
            "telephone_number": "866-268-9616",
            "fax_number": "541-504-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "442 SW UMATILLA AVE STE 200",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977567039",
            "telephone_number": "866-268-9616",
            "fax_number": "541-504-3907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE DENTAL CLINICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-20",
        "last_updated": "2011-09-23",
        "status": "A",
        "authorized_official_last_name": "SHIRTCLIFF",
        "authorized_official_first_name": "R",
        "authorized_official_middle_name": "MIKE",
        "authorized_official_title_or_position": "PRESIDENT/CEO/DENTAL DIRECTOR",
        "authorized_official_telephone_number": "866-268-9616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; 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.