SPRINGFIELD KIDS DENTIST LLC NPI 1831603018

NPI Information

NPI: 1831603018
Provider Name: SPRINGFIELD KIDS DENTIST LLC
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
5895 MAIN ST
SPRINGFIELD, OR
ZIP 97478
Phone: (541) 654-4996
Get Directions

SPRINGFIELD KIDS DENTIST LLC is a pediatric dentistry dentist in Springfield, OR. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. SPRINGFIELD KIDS DENTIST LLC NPI is 1831603018. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5895 MAIN ST
SPRINGFIELD, OR
ZIP 97478-961
Phone: (541) 654-4996
Fax: (541) 505-8463

The provider's authorized official is Femina Jane Bedolla .
The authorized official title is Operations Officer and has the following contact phone number (541) 844-3113.

The enumeration date for this NPI number is 11/26/2017 and was last updated on 11/26/2017.

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	1223P0221X	Dentist	Pediatric Dentistry	D8929	OREGON	Yes

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
1	1528268281	OTHER		PRIVATE INSURANCE
2	279295	MEDICAID	OREGON

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: 5/5/2024

NPI Synchronization or Removal

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