OREGON COMMUNITY DENTAL CARE (NPI# 1629343140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629343140 |
| Entity Type | Organization |
| Organization Name | OREGON COMMUNITY DENTAL CARE |
| Practice Address |
671 Sw Main St Winston OR 97496-6571 |
| Mailing Address |
442 Sw Umatilla Ave Ste 200 Redmond OR 97756-7039 |
| Practice Telephone | 8884680022 |
| Practice Fax Number | 5415043907 |
| Mailing Telephone | 8884680022 |
| Mailing Fax Number | 5415043907 |
| Enumeration Date | 2012-03-16 |
| Last Update Date | 2012-03-16 |
| Authorized Official Name | R. MIKE SHIRTCLIFF (PRESIDENT/CEO) |
| Authorized Official Telephone | 8884680022 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | OREGON COMMUNITY DENTAL CARE | 442 Sw Umatilla Avenue Suite 200, Redmond, OR 97756 |
| Street Address |
671 SW MAIN ST |
| City | WINSTON |
| State | OR |
| Zip Code | 97496-6571 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255547501 | Carol Ann Lockwood | Dentist | 671 Sw Main St, Winston, OR 97496-6571 | 2007-05-15 |
| 1154975001 | Jacob Mcavoy | Physician Assistant | 671 Sw Main St, Winston, OR 97496-6571 | 2019-07-30 |
| 1861967648 | Adapt | Clinic/Center | 671 Sw Main St, Winston, OR 97496-6571 | 2018-10-09 |
| 1588168801 | Amanda Alice Gray | Dental Hygienist | 671 Sw Main St, Winston, OR 97496-6571 | 2018-03-21 |
| 1295251072 | Suzanne Ruth Dudek | Family Medicine | 671 Sw Main St, Winston, OR 97496-6571 | 2017-08-14 |
| 1811425564 | Lisa Crawford | Social Worker | 671 Sw Main St, Winston, OR 97496-6571 | 2017-05-25 |
| 1265983431 | Marcy Ellen Dean | Registered Nurse | 671 Sw Main St, Winston, OR 97496-6571 | 2016-10-21 |
| 1003285271 | Louis Darling | Social Worker | 671 Sw Main St, Winston, OR 97496-6571 | 2015-09-17 |
| 1083016695 | Cora G Hart | Psychologist | 671 Sw Main St, Winston, OR 97496 | 2014-09-25 |
| 1386073898 | Michelle Hubbard | Dental Hygienist | 671 Sw Main St, Winston, OR 97496-6571 | 2013-11-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679957708 | Second Wind Mental Health Clinic | Clinic/Center | 11 Sw Brantley Drive, Winston, OR 97496 | 2015-07-18 |
| 1992951305 | Ronald Forrest Tribble | Dentist | 90 Nw Glenhart, Winston, OR 97496 | 2008-08-18 |
| 1396923884 | Karen S Triplett | Nurse Practitioner | 92 Nw Glenhart Ave, Winston, OR 97496 | 2008-02-06 |
| 1629168166 | Adolescent Day Treatment Center Inc of Douglas County | Clinic/Center | 671 S.w. Main, Winston, OR 97496 | 2006-10-13 |
| 1184610123 | Ronald F. Tribble, Dmd, PC | Dentist | 90 Nw Glenhart Ave, Winston, OR 97496 | 2005-09-26 |
| 1912160169 | Kathryn Elizabeth Dailey | Social Worker | 671 Sw Main, Winston, OR 97496 | 2008-07-08 |
| 1912061755 | Adapt | Family Medicine | 671 Sw Main, Winston, OR 97496-0012 | 2006-12-19 |
| 1144426271 | Rebecca Lin Duffy | Nurse Practitioner | 311 Sw Main, Winston, OR 97496-0771 | 2007-06-25 |
| 1861843310 | Stacy J Nielsen, Lcsw, LLC | Community/Behavioral Health | 11 Sw Brantley Dr, Winston, OR 97496-4526 | 2016-06-27 |
| 1033462866 | Kathryn Vara | Registered Nurse | 77 Sw Brantley Dr, Winston, OR 97496-4526 | 2012-10-17 |
| Find all providers in zip 97496 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992951305 | Ronald Forrest Tribble | Dentist | 90 Nw Glenhart, Winston, OR 97496 | 2008-08-18 |
| 1184610123 | Ronald F. Tribble, Dmd, PC | Dentist | 90 Nw Glenhart Ave, Winston, OR 97496 | 2005-09-26 |
| 1609868082 | Harold Timothy Hall | Dentist | 351 Main St, Winston, OR 97496-9503 | 2005-08-22 |
| 1053793943 | Joshua T Myers, Dds, P.C. | Dentist | 90 Nw Glenhart Ave, Winston, OR 97496-9660 | 2015-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700486438 | Jane Jeeyoon Kim | Dentist | 14425 Sw Allen Blvd # 1, Beaverton, OR 97005-4402 | 2020-10-30 |
| 1780283556 | Ziyad Amir Kadir | Dentist | 300 Tatone St, Boardman, OR 97818-7900 | 2020-10-22 |
| 1295333912 | John Andrew Fawcett | Dentist | 214 Jersey St, Silverton, OR 97381-1627 | 2020-10-14 |
| 1629685920 | Alexandroff Dmd PC | Dentist | 1085 E Harbor Drive, Warrenton, OR 97146 | 2020-09-30 |
| 1760097034 | Hannah Glazunov | Dentist | 4970 S Landing Dr Unit 302, Portland, OR 97239-5900 | 2020-09-13 |
| 1235742198 | Geoffrey Houf | Dentist | 5880 Ne Cornell Rd Ste D, Hillsboro, OR 97124-9075 | 2020-08-28 |
| 1124631650 | Sugandha Gupta | Dentist | 2561 Nw 167th Ave, Beaverton, OR 97006-7643 | 2020-08-25 |
| 1609489137 | Open Door Dental Group PC | Dentist | 1710 E Pine St Ste A, Central Point, OR 97502-2811 | 2020-08-25 |
| 1720698566 | Travis Alcorn | Dentist | 2750 Kingwood St, Florence, OR 97439-9556 | 2020-08-06 |
| 1811506322 | Ruiwei Liang | Dentist | 547 Se 73rd Ave, Hillsboro, OR 97123-6199 | 2020-07-30 |
| 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.