WILLAMETTE VALLEY ORAL & MAXILLOFACIAL SURGEY, INC. (NPI# 1144575267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144575267 |
| Entity Type | Organization |
| Organization Name | WILLAMETTE VALLEY ORAL & MAXILLOFACIAL SURGEY, INC. |
| Practice Address |
250 Church St Se Ste 102 Salem OR 97301-3758 |
| Practice Telephone | 5035811999 |
| Practice Fax Number | 5035811107 |
| Mailing Telephone | 5035811999 |
| Mailing Fax Number | 5035811107 |
| Enumeration Date | 2012-07-15 |
| Last Update Date | 2012-07-15 |
| Authorized Official Name | HOLLY J EYRE (OFFICE MANAGER) |
| Authorized Official Telephone | 5035811999 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
D6858 | OR | Dental Providers |
| Street Address |
250 CHURCH ST SE STE 102 |
| City | SALEM |
| State | OR |
| Zip Code | 97301-3758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164712022 | Travis Jon Hamilton | Dentist | 250 Church St Se Ste 102, Salem, OR 97301-3758 | 2011-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205450970 | Jehan Seals | Behavior Technician | 3400 State St Set G750, Salem, OR 97301 | 2020-05-29 |
| 1093335929 | Sterling Recovery, LLC | Dietitian, Registered | 3758 Amber St Ne #105, Salem, OR 97301 | 2020-04-21 |
| 1760018360 | Riverfront Mental Health LLC | Counselor | 338 State St, Suite 985, Salem, OR 97301 | 2020-03-16 |
| 1871126888 | Amity Beth Haddon Maxwell | Social Worker | Oregon State Hospital, 2600 Center St Ne, Salem, OR 97301 | 2020-02-18 |
| 1861042632 | Brenda Grizelda Vargas | Behavioral Analyst | 3400 State Ste Ste G750, Salem, OR 97301 | 2019-09-13 |
| 1588213177 | Natalie Stone | Registered Nurse | 2045 Siverton Rd Ne, Salem, OR 97301 | 2019-09-06 |
| 1588228720 | Jeramy Disenso | Counselor | 270 Cottage St Ne, Salem, OR 97301 | 2019-04-23 |
| 1801353297 | Gwendolyn Kersey | Registered Nurse | 2600 Center St Ne Oregon State Hospital, Salem, OR 97301 | 2019-02-21 |
| 1841769114 | Spine Clinic PC | Massage Therapist | 1281 Lancaster Drive Ne, Salem, OR 97301 | 2018-11-16 |
| 1013482132 | Kellie Linn Hansen | Physical Therapist | 4049 Market St Se, Salem, OR 97301 | 2018-10-04 |
| Find all providers in zip 97301 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831686468 | Jev A. Clark, Dmd, Md, LLC | Dentist | 120 Ramsgate Sq S Ste 110, Salem, OR 97302-5870 | 2018-04-19 |
| 1164712022 | Travis Jon Hamilton | Dentist | 250 Church St Se Ste 102, Salem, OR 97301-3758 | 2011-04-12 |
| 1124242813 | Dennis Douglas Johnson | Dentist | 410 Lancaster Dr Ne, Suite A, Salem, OR 97301-4794 | 2007-04-12 |
| 1407981855 | George Michael Koumaras | Dentist | 143 Bogey Ln, Salem, VA 24153-6858 | 2007-02-23 |
| 1578666426 | John C Tackett | Dentist | 102 N Harrison St, Salem, IN 47167-1426 | 2006-09-06 |
| 1609878172 | James M. Eyre Jr. | Dentist | 250 Church St Se, Ste 102, Salem, OR 97301-8500 | 2005-08-13 |
| 1588665723 | David Wesley Howerton | Dentist | 2266 Mission St Se, Salem, OR 97302-1267 | 2005-08-10 |
| 1447258223 | Gary Theodore Pederson | Dentist | 1565 Liberty St Se, Salem, OR 97302-4345 | 2005-07-14 |
| 1174520548 | Martin J. Mehr | Dentist | 120 Ramsgate Sq S, Suite 110, Salem, OR 97302-5868 | 2005-06-30 |
| 1972996197 | Southwest Virginia Oral & Maxillofacial Surgery, Pllc | Dentist | 1940 Braeburn Dr, Suite A, Salem, VA 24153-7383 | 2015-03-12 |
| Find all providers in SALEM | ||||
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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.