CAPITOL DENTAL GROUP NPI 1255889333

NPI Information

NPI: 1255889333
Provider Name: CAPITOL DENTAL GROUP
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

CLIA Number: 38D2262019

Address:
3000 MARKET ST NE
SUITE 228
SALEM, OR
ZIP 97301
Phone: (503) 587-7162
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CAPITOL DENTAL GROUP is a dental clinic center in Salem, OR. CAPITOL DENTAL GROUP NPI is 1255889333. The provider is registered as an organization entity type.

The provider's business location address is:

3000 MARKET ST NE
SUITE 228
SALEM, OR
ZIP 97301-882
Phone: (503) 587-7162
Fax: (503) 581-0043

The provider's authorized official is Staci Comer .
The authorized official title is Dental Program Director and has the following contact phone number (971) 205-7475.

The CLIA number assigned to this NPI record is 38D2262019 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/16/2016 and was last updated on 9/16/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	H7259	OREGON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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