MOSAIC MEDICAL DENTAL (NPI# 1659888279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659888279 |
| Entity Type | Organization |
| Organization Name | MOSAIC MEDICAL DENTAL |
| Other Organization Name | MOSAIC MEDICAL BEND DENTAL |
| Practice Address |
2084 Ne Professional Ct Bend OR 97701-6077 |
| Mailing Address |
600 Sw Columbia St Ste 6210 Bend OR 97702-1099 |
| Practice Telephone | 5413833005 |
| Practice Fax Number | 5413831883 |
| Mailing Telephone | 5413833005 |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2018-02-28 |
| Authorized Official Name | MEGAN HAASE (CEO) |
| Authorized Official Telephone | 5413833005 |
| Is Organization Subpart | Y |
| Parent Organization Name | MOSAIC MEDICAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 182960 | 05 |
| Other Name | Type Code |
|---|---|
| Mosaic Medical Bend Dental | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942738588 | Mosaic Medical Dental | Clinic/Center | 1250 Sw Veterans Way, Redmond, OR 97756-2585 | 2017-05-26 |
| 1174066963 | Mosaic Medical Dental | Clinic/Center | 375 Nw Beaver St, Suite 101, Prineville, OR 97754-1802 | 2016-11-28 |
| Street Address |
2084 NE PROFESSIONAL CT |
| City | BEND |
| State | OR |
| Zip Code | 97701-6077 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902881592 | Joeth D. Ryan | Physician Assistant | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2005-12-07 |
| 1801445473 | Mosaic Medical | Clinic/Center | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2019-09-06 |
| 1821591199 | Lauren Kaimana Oakley | Dental Hygienist | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2018-03-13 |
| 1528560091 | Mosaic Medical | Clinic/Center | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2018-03-01 |
| 1407309115 | Megan L. Barrett | Registered Nurse | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2016-07-28 |
| 1811314040 | William Featherston Gilmore IIi | Pediatrics | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2014-03-26 |
| 1790109189 | Lindsey Renae Overstreet | Social Worker | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2014-02-06 |
| 1972938942 | Kerry Adele Gillette | Physician Assistant | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2013-09-10 |
| 1851732085 | Joshua Reiher | Family Medicine | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2013-07-16 |
| 1982048211 | Abby P. Hendricks | Pediatrics | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2013-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104465525 | Andrew Kyle Burzynski | Denturist | 853 Ne 4th St., Bend, OR 97701 | 2020-01-02 |
| 1013480714 | Andrew Traut | Specialist/Technologist | Oregon State Force Lab, 2200 Ne Neff Rd Suite 202, Bend, OR 97701 | 2019-01-04 |
| 1871063917 | Calley Asbill, Nd LLC | Chiropractor | 2146 Ne 4th Street, Suite 160, Bend, OR 97701 | 2018-12-02 |
| 1902372212 | Carisa S Battin | Counselor | 361 Ne Franklin Avenue Bldg E #4, Bend, OR 97701 | 2018-10-15 |
| 1366921223 | Hillside Eye Center LLC | Ophthalmology | 625 Nw Colorado Avenue, Bend, OR 97701 | 2018-08-11 |
| 1528545514 | Kellie Michiko Kawasaki-jones | Dentist | 62968 Ob Riley Road, Suite 12, Bend, OR 97701 | 2018-07-23 |
| 1992255327 | Shelby Chiropractic | Chiropractor | 561 Ne Bellevue Dr Ste 102, Bend, OR 97701 | 2016-10-10 |
| 1144671520 | Kevin Richard Pett | Acupuncturist | 39 Nw Louisanna Ave., Hawthorn Healing Arts Center, Bend, OR 97701 | 2016-06-27 |
| 1912357500 | Sheldon Shawn Doveri | Driver | 233 Nw Revere Ave, Bend, OR 97701 | 2016-06-15 |
| 1740647411 | Anne Power | Homeopath | 2100 Ne Neff Rd Suite B, Bend, OR 97701 | 2016-01-26 |
| Find all providers in zip 97701 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184273757 | Mosaic Medical | Clinic/Center | 2965 Ne Conners Ave Ste 280, Bend, OR 97701-7753 | 2019-09-06 |
| 1801445473 | Mosaic Medical | Clinic/Center | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2019-09-06 |
| 1528560091 | Mosaic Medical | Clinic/Center | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2018-03-01 |
| 1023523073 | Mosaic Medical | Clinic/Center | 2577 Ne Courtney Dr Ste 100, Bend, OR 97701-7638 | 2017-12-12 |
| 1164820270 | Mosaic Medical | Clinic/Center | 230 Ne 6th St, Bend, OR 97701-5103 | 2014-12-05 |
| 1346656444 | Mosaic Medical | Clinic/Center | 1700 Se Tempest Dr, Bend, OR 97702-1884 | 2014-07-09 |
| 1649681560 | Mosaic Medical | Clinic/Center | 2150 Ne Daggett Ln, Bend, OR 97701-6560 | 2014-05-13 |
| 1215368329 | Mosaic Medical | Clinic/Center | 1128 Nw Harriman St, Bend, OR 97701-1947 | 2013-11-29 |
| 1710328992 | Mosaic Medical | Clinic/Center | 2965 Ne Conners Ave, Suite 280, Bend, OR 97701-7753 | 2013-07-16 |
| 1588902860 | Mosaic Medical Mobile Unit | Clinic/Center | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2013-01-22 |
| Find all providers in BEND | ||||
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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.