GRANTS PASS DENTAL, LLC (NPI# 1699869156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699869156 |
| Entity Type | Organization |
| Organization Name | GRANTS PASS DENTAL, LLC |
| Practice Address |
118 Ne Jackson St Grants Pass OR 97526 |
| Practice Telephone | 5414764511 |
| Practice Fax Number | 5414799006 |
| Mailing Telephone | 5414764511 |
| Mailing Fax Number | 5414799006 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. TYLER D WRIGHT (OWNER) |
| Authorized Official Telephone | 5414764511 |
| Authorized Official Credential | D.M.D. |
| 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 | GRANTS PASS DENTAL, LLC | 118 Ne Jackson St, Grants Pass, OR 97526 |
| Street Address |
118 NE JACKSON ST |
| City | GRANTS PASS |
| State | OR |
| Zip Code | 97526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437110012 | Jed Ledesma | Dentist | 118 Ne Jackson St, Grants Pass, OR 97526-1644 | 2006-03-31 |
| 1174618532 | Tyler D Wright | Dentist | 118 Ne Jackson St, Grants Pass, OR 97526 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205476777 | Kyla M Mccormick | Peer Specialist | 109 Nw Manzanita Avenue, Grants Pass, OR 97526 | 2020-01-13 |
| 1164076469 | Alicia Yvonne Hansen | Counselor | 1055 Clarey St., Grants Pass, OR 97526 | 2019-07-25 |
| 1841842598 | Michael Liam Reynolds, Dds, LLC | Dentist | 984 Ne 8th Street, Grants Pass Oregon, Grants Pass, OR 97526 | 2019-07-12 |
| 1881254746 | Brandi Mccrorey | Counselor | 418 Ne 6th Street, Suite 102, Grants Pass, OR 97526 | 2019-06-13 |
| 1700364502 | Premier Community Supports, LLC. | Day Training, Developmentally Disabled Services | 1439 Ne 6th St Ste C, Grants Pass, OR 97526 | 2018-08-02 |
| 1821584509 | Stefani Mcintyre | Massage Therapist | 1590 Se N Street, Warehouse #1574, Grants Pass, OR 97526 | 2018-07-06 |
| 1114467438 | Sandra P Martin | Chiropractor | 333 Sw 5th St. Suite B, Grants Pass, OR 97526 | 2017-03-06 |
| 1801347612 | Maci Wageman | Counselor | 1215 Sw G St Grants Pass Oregon 97526, Grants Pass, OR 97526 | 2016-10-17 |
| 1902353907 | Optimal Health of Southern Oregon, LLC | Family Medicine | 1600 Nw 6th St South Suite, Grants Pass, OR 97526 | 2016-09-07 |
| 1982150793 | Tanya White | Counselor | 402 Nw Fstreet, Grants Pass, OR 97526 | 2016-08-31 |
| Find all providers in zip 97526 | ||||
| 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 |
|---|---|---|---|---|
| 1841842598 | Michael Liam Reynolds, Dds, LLC | Dentist | 984 Ne 8th Street, Grants Pass Oregon, Grants Pass, OR 97526 | 2019-07-12 |
| 1649831991 | Paul Wayne Lamoreau | Dentist | 200 Ne Terry Ln Unit D, Grants Pass, OR 97526-4805 | 2019-06-27 |
| 1851885206 | Shane S Huish | Dentist | 1825 Nw Hawthorne Ave, Grants Pass, OR 97526-1043 | 2018-06-19 |
| 1265815799 | Rogue Valley Family Dentistry LLC | Dentist | 1873 Williams Hwy Ste 1a, Grants Pass, OR 97527-5843 | 2015-07-01 |
| 1376751875 | Bigelow and Pastrell Dentistry | Dentist | 1050 Sw Grandview Ave, Grants Pass, OR 97527 | 2007-05-18 |
| 1073734463 | George R Olfson, IIi | Dentist | 1212 Ne 7th St, Grants Pass, OR 97526-1424 | 2007-05-01 |
| 1245363985 | John Allen Hendy | Dentist | 1501 Ne 6th St, Suite 1a, Grants Pass, OR 97526-1034 | 2007-03-13 |
| 1437200615 | Laura Michelle Johnson | Dentist | 1002 Ramsey Ave, Grants Pass, OR 97527-5816 | 2007-01-15 |
| 1134291081 | Richard B Hill | Dentist | 1035 Ne 6th St, Ste. B, Grants Pass, OR 97526 | 2006-11-15 |
| 1578671574 | Donald Jerome Lanahan | Dentist | 824 Ne A St, Grants Pass, OR 97526-2212 | 2006-08-29 |
| Find all providers in GRANTS PASS | ||||
| City | GRANTS PASS |
| Zip Code | 97526 |
Please comment or provide details below to improve the information on GRANTS PASS DENTAL, LLC.
| 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.