PEDIATRIC DENTISTRY OF SALEM LLC (NPI# 1184831083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184831083 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC DENTISTRY OF SALEM LLC |
| Practice Address |
2020 Commercial St Se Salem OR 97302-5208 |
| Practice Telephone | 5033647545 |
| Practice Fax Number | 5035407911 |
| Mailing Telephone | 5033647545 |
| Mailing Fax Number | 5035407911 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. WESTON WILLARD HERINGER III (PARTNER) |
| Authorized Official Telephone | 5033647545 |
| Authorized Official Credential | D.M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
4631 | OR | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
7703 | OR | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | TAXONOMY CODE | 1223PO221X | 01 |
| OR | 233143 | 05 | |
| OR | 087163 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PEDIATRIC DENTISTRY OF SALEM LLC | 2020 Commercial St Se, Salem, OR 97301 |
| Street Address |
2020 COMMERCIAL ST SE |
| City | SALEM |
| State | OR |
| Zip Code | 97302-5208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598821944 | Weston Willard Heringer Jr. | Dentist | 2020 Commercial St Se, Salem, OR 97302 | 2006-12-29 |
| 1700933959 | Weston W Heringer IIi | Dentist | 2020 Commercial St Se, Salem, OR 97302-5208 | 2007-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
| 1598223737 | Michael Robert Martini | Counselor | 960 Liberty Rd Se Suite 120, Salem, OR 97302 | 2019-03-06 |
| 1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
| 1649762733 | Joseph Bochsler | Physical Therapist | 3220 Liberty Rd. S., Salem, OR 97302 | 2018-06-04 |
| 1922533652 | Brianne Elizabeth Sischo | Licensed Practical Nurse | 3871 Fairview Industrial Dr. Se Ste, 150, Salem, OR 97302 | 2017-05-01 |
| 1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
| 1720529803 | Nicholas Forsberg | Massage Therapist | 126 Mize Rd S, Salem, OR 97302 | 2017-03-09 |
| 1437691078 | Kimo Mahi | Specialist/Technologist, Other | 2373 Kuebler Rd. S, Salem, OR 97302 | 2016-11-14 |
| 1588113278 | New Life Family Medicine LLC | Clinic/Center | 842 Commercial Street Ne, Salem, OR 97302 | 2016-09-23 |
| 1073060117 | Susan Morag Robnett | Counselor | 912 Fir Street South, Salem, OR 97302 | 2016-09-07 |
| Find all providers in zip 97302 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740670009 | Ian Bell | Dentist | 140 Ramsgate Sq S Ste 120, Salem, OR 97302-5873 | 2015-01-26 |
| 1942551791 | Roger C. Dow, Dmd PC | Dentist | 140 Ramsgate Sq Se, Suite 110, Salem, OR 97302 | 2012-09-19 |
| 1598821944 | Weston Willard Heringer Jr. | Dentist | 2020 Commercial St Se, Salem, OR 97302 | 2006-12-29 |
| 1003917410 | Jeffrey C Phillips | Dentist | 1109 Liberty Circle S, Salem, OR 97306 | 2006-09-26 |
| 1922112333 | Roger Charles Dow | Dentist | 140 Ramsgate Sq S, Suite 110, Salem, OR 97302-5871 | 2006-08-19 |
| 1457376782 | Sean A Cooper | Dentist | 1105 12th St Se, Salem, OR 97302-2810 | 2006-07-13 |
| 1235116419 | J Chris Martin | Dentist | 1625 Commercial St Se, Salem, OR 97302-4311 | 2005-12-28 |
| 1376530535 | Stuart S Gould | Dentist | 116 Highland Ave, Salem, MA 01970-2723 | 2005-10-03 |
| 1043869191 | Acorn Dentistry for Kids - West Salem, LLC | Dentist | 1049 Edgewater St Nw, Salem, OR 97304-4046 | 2019-09-10 |
| 1598320111 | Salem Family Dental and Orthodontics PC | Dentist | 10 Federal St Ste 16, Salem, MA 01970-3875 | 2019-05-08 |
| Find all providers in SALEM | ||||
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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.