SOUTHERN OREGON ORAL AND MAXILLOFACIAL SURGEONS (NPI# 1093746174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093746174 |
| Entity Type | Organization |
| Organization Name | SOUTHERN OREGON ORAL AND MAXILLOFACIAL SURGEONS |
| Practice Address |
3162 State St Medford OR 97504-8450 |
| Practice Telephone | 5417791184 |
| Practice Fax Number | 5417739885 |
| Mailing Telephone | 5417791184 |
| Mailing Fax Number | 5417739885 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | NICOLE RIPPLINGER (OFFICE MANAGER) |
| Authorized Official Telephone | 5417791184 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
D7720 | OR | Dental Providers |
| Street Address |
3162 STATE ST |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-8450 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467060293 | Omscor LLC | Dentist | 3162 State St, Medford, OR 97504-8450 | 2020-07-17 |
| 1639514672 | Matthew E Myers | Dentist | 3162 State St, Medford, OR 97504 | 2013-05-03 |
| 1588986525 | Oral and Maxillofacial Surgery | Dentist | 3162 State St, Medford, OR 97504-8450 | 2010-02-18 |
| 1841473121 | Bruce S Logan | Dentist | 3162 State St, Medford, OR 97504-8450 | 2007-12-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 1223P0106X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Pathology |
| The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669435806 | Bryan R. Harvey | Dentist | 331 Warner Milne Rd, Oregon City, OR 97045-4045 | 2006-04-10 |
| 1508827478 | Wei-yuhg Yih | Dentist | 611 Sw Campus Dr, Sd-515, Portland, OR 97239-3001 | 2006-03-30 |
| 1790229888 | Northwest Oral Pathology | Dentist | 12254 Sw Garden Pl, Tigard, OR 97223-8246 | 2016-12-08 |
| 1629286273 | Northwest Oral & Maxillofacial Surgeons, LLC | Dentist | 24850 Se Stark St, Suite 100, Gresham, OR 97030-8316 | 2007-05-18 |
| 1720044126 | Keith Edward Krueger | Dentist | 1475 Sw Chandler Ave, Suite 101, Bend, OR 97702-3238 | 2006-04-25 |
| 1063413722 | Henry Cooke Windell | Dentist | 24850 Se Stark St, Gresham, OR 97030-8316 | 2005-08-03 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.