SOUTH LANE CHILDREN'S DENTAL CLINIC


Address: 1275 S River Rd, Cottage Grove, OR 97424-3906
Phone: 5415207137

SOUTH LANE CHILDREN'S DENTAL CLINIC (NPI# 1497190821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1497190821
Entity Type Organization
Organization Name SOUTH LANE CHILDREN'S DENTAL CLINIC
Practice Address 1275 S River Rd
Cottage Grove
OR 97424-3906
Practice Telephone 5415207137
Mailing Telephone 5415207137
Enumeration Date 2013-04-29
Last Update Date 2013-04-29
Authorized Official Name MRS. COURTNEY JANE LONG (DENTAL CARE COORDINATOR)
Authorized Official Telephone 5415207137
Authorized Official Credential EFDA
Is Organization Subpart Y
Parent Organization Name SOUTH LANE SCHOOL DISTRICT

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 251V00000X Voluntary or Charitable ========= OR Agencies

Office Location

Street Address 1275 S RIVER RD
City COTTAGE GROVE
State OR
Zip Code 97424-3906

Providers in the same location

NPI Name Taxonomy Address Enumeration
1801350194 Jessica Marie Ostrander Dental Hygienist 1275 S River Rd, Cottage Grove, OR 97424-3906 2019-01-30
1790259679 Tia Rae Morehouse Dental Hygienist 1275 S River Rd, Cottage Grove, OR 97424-3906 2019-01-14

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1851936157 Naomi Higgs Physical Therapy Assistant 515 Grant St, Cottage Grove, OR 97424 2019-11-10
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1215420625 Zachary Booth Student in an Organized Health Care Education/Training Program 28188 Cottage Grove Lorane Rd, Cottage Grove, OR 97424 2018-06-11
1124404090 Eileen Nittler Social Worker 1345 Birch Avenue, Cottage Grove, OR 97424 2015-08-03
1851799787 Kathryn Brooks Licensed Practical Nurse 520 Patrick Loop, Cottage Grove, OR 97424 2014-12-09
1558767814 Michele Renee Savage Orthotic Fitter 148 Gateway Blvd, Cottage Grove, OR 97424 2014-11-14
1730598558 John Mansfield Pharmacist 120 Andrew Drive, Cottage Grove, OR 97424 2014-08-06
1700213493 Aspen Injury Center LLC Chiropractor 1260 East Main Street, Cottage Grove, OR 97424 2013-09-26
1609172956 Megan Olds Counselor 37 South 6th Street, Cottage Grove, OR 97424 2011-02-03
1144530726 Monica G Radley Counselor 1345 Birch Ave., Cottage Grove, OR 97424 2010-10-15
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Taxonomy Information

Taxonomy Code 251V00000X
Grouping Agencies
Classification Voluntary or Charitable

Taxonomy Definition

Definition to come...

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1558859504 Rochelle Diane Hamilton Voluntary or Charitable 2802 Adams Ave, La Grande, OR 97850-5267 2018-04-25
1104329523 Corvallis Neighborhood Housing Services Voluntary or Charitable 257 Sw Madison Ave Ste 117, Corvallis, OR 97333-4757 2018-03-12
1912432279 Bit By Bit Voluntary or Charitable 38578 Highway 99w, Corvallis, OR 97330-9320 2017-04-25
1215471909 Northwest Mothers Milk Bank Voluntary or Charitable 15875 Sw 74th Ave Ste 100, Tigard, OR 97224-7934 2016-12-14
1568906402 Community Helping Addicts Negotiate Change Effectively Voluntary or Charitable 238 3rd Ave Se, Albany, OR 97321-2857 2016-12-12
1104375468 Family Tree Relief Nursery Voluntary or Charitable 1005 Nw Springhill Dr, Albany, OR 97321-1748 2016-09-28
1538516265 Kemple Memorial Children's Dental Clinic Voluntary or Charitable 1029 Nw 14th St Ste 101, Bend, OR 97703-2189 2016-05-23
1487070181 United Community Action Network Voluntary or Charitable 280 Ne Kenneth Ford Dr, Roseburg, OR 97470-1034 2014-03-05
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Competitor

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City COTTAGE GROVE
Zip Code 97424

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Dataset Information

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.

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