DR. DAVID MARK MCCOLLOUGH (NPI# 1265476188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265476188 |
| Entity Type | Individual |
| Full Name | DR. DAVID MARK MCCOLLOUGH |
| Credential | DMD MS |
| Practice Address |
3750 Chemawa Rd Ne Chemawa Indian Health Center Salem OR 97305-1111 |
| Mailing Address |
3750 Chemawa Rd Ne Salem OR 97305-1111 |
| Practice Telephone | 5033047600 |
| Practice Fax Number | 5033047677 |
| Mailing Telephone | 5033047664 |
| Mailing Fax Number | 5033047677 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
4022 | AL | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 278159 | 05 |
| Street Address |
3750 CHEMAWA RD NE CHEMAWA INDIAN HEALTH CENTER |
| City | SALEM |
| State | OR |
| Zip Code | 97305-1111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336142942 | Michael Paul Kelly | Pharmacist | 3750 Chemawa Rd Ne, Salem, OR 97305-1119 | 2005-05-27 |
| 1962051516 | Diana Morrow | Art Therapist | 3750 Chemawa Rd Ne, Salem, OR 97305-1198 | 2019-09-06 |
| 1205316734 | Jessica Rae Hirsh Angle | Art Therapist | 3750 Chemawa Rd Ne, Salem, OR 97305-1119 | 2018-08-15 |
| 1245783133 | Ashley-drake Estes | Counselor | 3750 Chemawa Rd Ne, Salem, OR 97305-1119 | 2016-07-27 |
| 1669828323 | Michelle Livingston | Registered Nurse | 3750 Chemawa Rd Ne, Salem, OR 97305-1119 | 2016-05-11 |
| 1073967832 | Connie Lynne Rutledge | Dental Hygienist | 3750 Chemawa Rd Ne, Salem, OR 97305 | 2016-04-19 |
| 1124491923 | Laura Teresa Hunker | Social Worker | 3750 Chemawa Rd Ne, Salem, OR 97305-1119 | 2015-11-03 |
| 1396117511 | Western Oregon Service Unit | Clinic/Center | 3750 Chemawa Rd Ne, Salem, OR 97305-1119 | 2015-10-27 |
| 1912373523 | Tracy Nelson | Registered Nurse | 3750 Chemawa Rd Ne, Salem, OR 97305-1119 | 2015-08-18 |
| 1467835462 | Katie Ann Shaw | Dental Hygienist | 3750 Chemawa Rd Ne, Salem, OR 97305-1119 | 2015-07-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821639147 | Christine Ann Featherstone | Social Worker | Chemawa Indian Health Center, 3750 Chemawa Road, Salem, OR 97305 | 2019-10-08 |
| 1962996553 | Erin Ann Wakefield | Non-emergency Medical Transport (VAN) | 2425 Fisher Rd Ne, Salem, OR 97305 | 2018-06-18 |
| 1770002271 | Traci L Lee | Case Manager/Care Coordinator | 3876 Beverly Ave Bldg G, Salem, OR 97305 | 2017-09-15 |
| 1952825762 | Matthew Paul Martin | Dentist | 2737 Lancaster Dr Ne Ste 150, Salem, OR 97305 | 2017-08-02 |
| 1043750367 | Sherri King | Physical Therapy Assistant | 4696 Reimann St Ne, Salem, OR 97305 | 2017-03-06 |
| 1760861314 | Amara Lenore Peterson | Counselor | 4347 Sunnyview Rd Ne, Salem, OR 97305 | 2015-05-28 |
| 1720467954 | Heather Rose | Community Health Worker | 4347 Sunnyview Road Ne, Salem, OR 97305 | 2015-05-20 |
| 1588057004 | Carmen Heidecke | Counselor | 4347 Sunnyview Rd. Ne, Salem, OR 97305 | 2015-03-08 |
| 1629476825 | Bryan James Greenaway | Audiologist | 3857 Wolverine St Ne Ste C-16, Salem, OR 97305 | 2014-12-21 |
| 1710300322 | Christopher Ryan | Counselor | 4385 Sunnyview Road Ne, Salem, OR 97305 | 2014-02-03 |
| Find all providers in zip 97305 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396134896 | Viktoria P. Talebian Dmd PC | Dentist | 128 Highland Avenue, Suite #1, Salem, MA 01970 | 2015-01-21 |
| 1861732927 | Reid Michael Amborn | Dentist | 1810 E Nob Hill St Se, Salem, OR 97302-5238 | 2013-02-26 |
| 1053605246 | Cole R Johnson | Dentist | 2755 Commercial St Se Ste 200, Salem, OR 97302-4991 | 2011-06-05 |
| 1457675738 | Thomas Orthodontics | Dentist | 424 State Road 198, Salem, UT 84653-4605 | 2010-03-16 |
| 1801012240 | Frank R Bailey Ddd Inc | Dentist | 2384 Southeast Blvd, Salem, OH 44460-3418 | 2007-04-17 |
| 1508904046 | Richard Horne Tate | Dentist | 701 S College Ave, Salem, VA 24153-5167 | 2007-02-04 |
| 1366518672 | Mcdonald Orthodontics | Dentist | 1855 West Nob Hill St Se, Suite 300, Salem, OR 97302 | 2006-11-28 |
| 1750455325 | Richard S Teel | Dentist | 1460 Commercial St Se, Salem, OR 97302-4308 | 2006-11-17 |
| 1922170208 | Earl Edmondson Gilder | Dentist | 3940 Lancaster Dr Ne, Salem, OR 97305-1450 | 2006-11-14 |
| 1013020031 | Viktoria Talebian | Dentist | 128 Highland Ave # 1, Salem, MA 01970-2724 | 2006-08-16 |
| 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.