CRISDENTAL EAST SALEM, LLC (NPI# 1558601385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1558601385 |
Entity Type | Organization |
Organization Name | CRISDENTAL EAST SALEM, LLC |
Practice Address |
3545 Lancaster Dr Ne Salem OR 97305-1435 |
Mailing Address |
3019 Nw Stewart Pkwy Ste 304, Box 311 Roseburg OR 97471-1602 |
Practice Telephone | 5416722747 |
Practice Fax Number | 5416722757 |
Mailing Telephone | 5416722747 |
Mailing Fax Number | 5416722757 |
Enumeration Date | 2013-02-14 |
Last Update Date | 2013-02-14 |
Authorized Official Name | MICHAEL J BRATLAND (OWNER) |
Authorized Official Telephone | 5416722747 |
Authorized Official Credential | DMD |
Is Organization Subpart | Y |
Parent Organization Name | CRISDENTAL GROUP, PC |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
Entity Type | Entity Name | Entity Address |
---|---|---|
Oregon Corporations, Companies and Business Names | CRISDENTAL EAST SALEM, LLC | 3545 Lancaster Drive Ne, Salem, OR 97305 |
Street Address |
3545 LANCASTER DR NE |
City | SALEM |
State | OR |
Zip Code | 97305-1435 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508400805 | Joanna Michelle Meas | Dental Hygienist | 3545 Lancaster Dr Ne, Salem, OR 97305-1435 | 2019-10-30 |
1255997235 | Christopher Peter Mccarthy | Denturist | 3545 Lancaster Dr Ne, Salem, OR 97305-1435 | 2019-05-15 |
1013433853 | Andres Adalbeto Aguilar Jr. | Denturist | 3545 Lancaster Dr Ne, Salem, OR 97305-1435 | 2017-08-14 |
1740651835 | Christina Marie Peterson | Dental Hygienist | 3545 Lancaster Dr Ne, Salem, OR 97305-1435 | 2015-10-14 |
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 | 1223G0001X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | General Practice |
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
Notes: Source: Academy of General Dentistry |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811557457 | Chadi Farag | Dentist | 25620 75th Street, Salem, WI 53168 | 2019-06-17 |
1528626660 | Stephanie Danielle Gibbons | Dentist | 5 Dawn St, Salem, NH 03079-3231 | 2019-06-04 |
1407414642 | Selma Moon Pierce | Dentist | 961 Glen Eden Ct Nw, Salem, OR 97304-2258 | 2019-06-03 |
1295392926 | Brock Jesse Nelson | Dentist | 631 Jason St Ne Ste 150, Salem, OR 97301-2750 | 2019-05-29 |
1023595899 | Gregory Lee Miller | Dentist | 3405 Derr Park Rd Se, Salem, OR 97310-0001 | 2018-07-25 |
1437643616 | Idylwood Dental LLC | Dentist | 4392 Liberty Road, Salem, OR 97302-6171 | 2018-06-20 |
1619428281 | William D. Bateman, Dmd, LLC | Dentist | 1995 Commercial St Se Ste 200, Salem, OR 97302-5291 | 2016-10-19 |
1134545494 | Caroline Wallace | Dentist | 103 S Colorado St, Salem, VA 24153-3848 | 2014-03-11 |
1275960296 | Amy Trevor | Dentist | 1595 Commercial St. Se, Salem, OR 97302 | 2013-10-04 |
1487929980 | King Dental PC | Dentist | 1855 W Nob Hill St Se Ste 200, Salem, OR 97302-5288 | 2012-03-15 |
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.