DANIEL J. DECILLIS, DDS, LLC (NPI# 1508428954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508428954 |
| Entity Type | Organization |
| Organization Name | DANIEL J. DECILLIS, DDS, LLC |
| Practice Address |
1144 Iowa St Ste A Ashland OR 97520-2385 |
| Practice Telephone | 5414824995 |
| Enumeration Date | 2019-07-06 |
| Last Update Date | 2019-07-06 |
| Authorized Official Name | DR. DANIEL DECILLIS (MANAGING MEMBER) |
| Authorized Official Telephone | 7045576101 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Soulsmile | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | DANIEL J. DECILLIS, DDS, LLC | 1144 Iowa St Ste A, Ashland, OR 97520 |
| Street Address |
1144 IOWA ST STE A |
| City | ASHLAND |
| State | OR |
| Zip Code | 97520-2385 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326545625 | Daniel Jordan Decillis | Dentist | 1144 Iowa St Ste A, Ashland, OR 97520 | 2018-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699390435 | Susan Kathleen Phelps | Massage Therapist | 280 E. Hersey St., Suite B17, Ashland, OR 97520 | 2020-06-08 |
| 1891276101 | William Charles Southworth | Internal Medicine | 866 Blaine St.., Ashland, OR 97520 | 2018-08-24 |
| 1730690959 | Eleyah Knight | Acupuncturist | 850 Siskyou Blvd. #6, Ashland, OR 97520 | 2017-10-15 |
| 1881117752 | Elizabeth Kristine Follett | Speech-Language Pathologist | 3265 Biddle Road, Medford, OR 97520 | 2017-07-21 |
| 1457895955 | Graham Collins Inc. | Counselor | 1600 Tolman Creek Rd, Ashland, OR 97520 | 2016-12-19 |
| 1720538010 | Kate Preskenis, Lmt, LLC | Massage Therapist | 823 Siskiyou Blvd., Ashland, OR 97520 | 2016-10-11 |
| 1366899445 | Nadejda Ioana Razi Robertson | Social Worker | 246 Second Street, Ashland, OR 97520 | 2016-05-19 |
| 1225496193 | Teena Summers | Marriage & Family Therapist | 200 Ohio St., Ashland, OR 97520 | 2016-02-05 |
| 1114392016 | Amanda Rose | Doula | 2233 Villard St Apt 203, Ashland, OR 97520 | 2015-12-04 |
| 1194194050 | Collins Inc. | Acupuncturist | 325 A. Street, Suite 1, Ashland, OR 97520 | 2015-09-22 |
| Find all providers in zip 97520 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
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|---|---|---|---|---|
| 1073065645 | Rush Dental Clinic | Clinic/Center | 46 Tyson Rd, Ashland, AL 36251 | 2016-10-31 |
| 1114383429 | Priest Dental, Inc | Clinic/Center | 910 Katherine Ave Ste A, Ashland, OH 44805-3692 | 2016-01-04 |
| 1942413638 | Paul E. Gray Dmd, Psc | Clinic/Center | 929 29th St, Ashland, KY 41101-3021 | 2007-05-08 |
| 1346868361 | Deborah Vincent Dmd Psc | Clinic/Center | 2741 Winchester Ave, Ashland, KY 41101-1928 | 2020-07-07 |
| 1780114801 | Katahdin Valley Health Center | Clinic/Center | 180 Presque Isle Rd, Ashland, ME 04732-3414 | 2017-06-13 |
| 1154775161 | Katahdin Valley Health Center | Clinic/Center | 33 Walker St, Ashland, ME 04732-3429 | 2016-04-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144834375 | Geoffrey R Clive Dds LLC | Clinic/Center | 11082 Se Oak St, Milwaukie, OR 97222-6692 | 2020-09-04 |
| 1508416041 | Columbia River Dentistry-gresham, LLC | Clinic/Center | 1700 Nw Civic Dr Ste 320, Gresham, OR 97030-3774 | 2019-09-17 |
| 1063065068 | Portland Dental Smiles | Clinic/Center | 732 Sw 3rd Ave Ste 202, Portland, OR 97204-2409 | 2019-07-18 |
| 1104478619 | David A Allen Dds | Clinic/Center | 1059 Royal Ave, Medford, OR 97504-6127 | 2019-07-15 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1164080875 | Central Point Dental LLC | Clinic/Center | 12338 Se 143rd Pl, Happy Valley, OR 97086-6545 | 2019-05-29 |
| 1285193003 | Hazelnut Dental LLC | Clinic/Center | 10773 Sw Beaverton-hillsdale Hwy, Ste B, Beaverton, OR 97005 | 2019-03-19 |
| 1558839498 | Kevin Prates Dds, PC | Clinic/Center | 1002 10th St Ste 1, Hood River, OR 97031-1564 | 2018-11-08 |
| 1063993749 | Roots Dental Stark LLC | Clinic/Center | 16338 Se Stark St, Portland, OR 97233-3958 | 2018-08-22 |
| 1528546330 | Christopher Brady Dmd LLC | Clinic/Center | 4707 Ne 102nd Ave Ste A, Portland, OR 97220-3393 | 2018-08-02 |
| Find all providers with the same taxonomy | ||||
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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.