MR. OTTO F MEZA (NPI# 1487859344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487859344 |
| Entity Type | Individual |
| Full Name | MR. OTTO F MEZA |
| Credential | L.D. |
| Practice Address |
1547 N Pacific Hwy Woodburn OR 97071-3656 |
| Mailing Address |
18324 Timbergrove Ct Lake Oswego OR 97035-8228 |
| Practice Telephone | 5039814001 |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122400000X | Denturist | DT-DO-460587 | OR | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | OREGON HEALTH LICENSING # | DT-DO-460587 | 01 |
| OR | DIV. MED. ASST. PROGRAMS | 127352 | 01 |
| Street Address |
1547 N PACIFIC HWY |
| City | WOODBURN |
| State | OR |
| Zip Code | 97071-3656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629628839 | Carla Frances Halvorson | Technician | 955 Carol St Apt D, Woodburn, OR 97071 | 2019-09-19 |
| 1851801856 | Angela Hill | Massage Therapist | 564 Ray J Glatt Cirle, Woodburn, OR 97071 | 2017-10-04 |
| 1154713295 | Theresa Donavant-butler | Massage Therapist | 564 Glatt Circle, Woodburn, OR 97071 | 2015-02-26 |
| 1710257878 | Darlene Jost-babin | Counselor | 693 Ray J Glatt Circle, Woodburn, OR 97071 | 2012-01-06 |
| 1932401437 | Marcelino Mauro Vera Ramirez | Chiropractor | 844 Pana Street, Woodburn, OR 97071 | 2010-12-03 |
| 1801110994 | Woodburn Cosmetic & Family Dentistry P.C. | Dentist | 1018 N. Boones Ferry Rd., Woodburn, OR 97071 | 2010-03-18 |
| 1568786911 | Woodburn Dental Group, P.C. | Dentist | 1034 N. Boones Ferry Rd., Woodburn, OR 97071 | 2010-03-15 |
| 1134384985 | Roberto Diaz Camarillo | Counselor | 399 Young Street, Woodburn, OR 97071 | 2008-07-22 |
| 1447431705 | Patricia Eddy | Physical Therapist | 1475 Mt Hood Avenue, Woodburn, OR 97071 | 2007-11-15 |
| 1992926471 | Marquis Physical Therapy & Spine Rehab, PC | Physical Therapist | 2241 Country Club Rd, Woodburn, OR 97071 | 2007-05-01 |
| Find all providers in zip 97071 | ||||
| Taxonomy Code | 122400000X |
| Grouping | Dental Providers |
| Classification | Denturist |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316576341 | Madeline M Cain | Denturist | 232 Ne Lincoln St Ste B, Hillsboro, OR 97124-3048 | 2020-04-02 |
| 1013549575 | Christopher Scott Mayo Jr. | Denturist | 937 Chetco Ave Ste. B, Brookings, OR 97415 | 2020-02-12 |
| 1104465525 | Andrew Kyle Burzynski | Denturist | 853 Ne 4th St., Bend, OR 97701 | 2020-01-02 |
| 1063074250 | Rajeev Rugi Siddappa | Denturist | 740 Avenue H, Seaside, OR 97138-6619 | 2019-07-08 |
| 1548760630 | Stephen Depirro II | Denturist | 740 Avenue H Ste 2, Seaside, OR 97138-6603 | 2018-02-15 |
| 1770083172 | Valley Denture Care LLC | Denturist | 535 N 5th St, Jacksonville, OR 97530-9704 | 2018-02-13 |
| 1407364177 | Joseph Rider | Denturist | 1523 Nw Canal Blvd Ste 101, Redmond, OR 97756-1340 | 2018-01-16 |
| 1821503293 | Calvin Daniel Smith | Denturist | 65 Irving Rd, Eugene, OR 97404 | 2017-12-07 |
| 1841642287 | Veronika Buliga | Denturist | 6842 Se 66th Ave, Portland, OR 97206-7449 | 2016-07-11 |
| 1528435237 | Lidiya Bogdan | Denturist | 4637 Se 128th Ave, Portland, OR 97236-3713 | 2015-08-28 |
| Find all providers with the same taxonomy | ||||
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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.