ADVANTAGE DENTAL GROUP PC NPI 1447812813

NPI Information

  • NPI: 1447812813
  • Provider Name: ADVANTAGE DENTAL GROUP, PC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Doing Business As: ADVANTAGE DENTAL ORAL HEALTH CENTER
  • CLIA Number: 38D2303587
  • Address: 1275 OREGON AVE SE
    BANDON, OR
    ZIP 97411
  • Phone: (541) 551-4022

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NPI Details

ADVANTAGE DENTAL GROUP, PC is a general practice dentist in Bandon, OR. The provider is 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. ADVANTAGE DENTAL GROUP, PC NPI is 1447812813. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Advantage Dental Oral Health Center.

The provider's business location address is:

1275 OREGON AVE SE
BANDON, OR
ZIP 97411-102
Phone: (541) 551-4022
Fax: (541) 516-4058

The provider's authorized official is Sharon Edmondson .
The authorized official title is Manger, Licensing & Credentialing and has the following contact phone number (629) 999-5014.

The CLIA number assigned to this NPI record is 38D2303587 - other - dental with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/5/2019 and was last updated on 10/25/2021.

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
11223G0001XDentistGeneral PracticeYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1500694195MEDICAIDOREGON

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: 11/21/2025

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