ZOLA DENTAL MEDFORD LLC (NPI# 1437646908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437646908 |
| Entity Type | Organization |
| Organization Name | ZOLA DENTAL MEDFORD LLC |
| Other Organization Name | BOLDT DENTAL |
| Practice Address |
922 E Main Medford OR 97504 |
| Mailing Address |
922 E Main St Medford OR 97504-7136 |
| Practice Telephone | 5094755367 |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2018-04-19 |
| Authorized Official Name | DR. ANTHONY MARK PAVENTY (OWNER) |
| Authorized Official Telephone | 5094755367 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D9209 | OR | Dental Providers |
| Other Name | Type Code |
|---|---|
| Boldt Dental | Former Legal Business Name - Organization |
| Street Address |
922 E MAIN |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504 |
| 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 |
| 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 |
| 1386002897 | Robert H Woodhouse | Social Worker | 1025 East Main Street, Medford, OR 97504 | 2016-01-29 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518573237 | Ishpreet Kaur | Dentist | 1759 N Riverside Ave, Medford, OR 97501-4628 | 2020-09-17 |
| 1154975076 | Patricia Rose Suing | Dentist | 1420 E Mcandrews Rd, Medford, OR 97504-6108 | 2019-07-29 |
| 1558920298 | Grace Jotika Dmd PC | Dentist | 0 Governors Ave Ste 1, Medford, MA 02155-3035 | 2019-06-06 |
| 1699266866 | Brent Hale | Dentist | 980 N Phoenix Rd Ste 101, Medford, OR 97504-9447 | 2018-05-23 |
| 1679060677 | James Alexander | Dentist | 42 Pitcher Ave, Medford, MA 02155-2101 | 2018-04-16 |
| 1245731934 | Betty Vasiliki Alepedis-stoukides | Dentist | 12 Badger Rd, Medford, MA 02155-2937 | 2018-02-27 |
| 1073014700 | Asnis Dental, Pllc | Dentist | 1645 Route 112 Ste A, Medford, NY 11763-3662 | 2018-02-27 |
| 1336689835 | Gary A. Rosenfeld, Dds, PC | Dentist | 2801 Route 112, Suite A, Medford, NY 11763-2568 | 2017-03-02 |
| 1801269261 | James Kolby Robinson | Dentist | 1291 E. Mcandrews Rd., Medford, OR 80238-2506 | 2015-11-06 |
| 1578942116 | Thomas Lloyd | Dentist | 4411 Brown Ridge Ter, Medford, OR 97504-9139 | 2015-05-28 |
| Find all providers in MEDFORD | ||||
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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.