WILLAMETTE VALLEY ORAL & MAXILLOFACIAL SURGERY, INC (NPI# 1619242591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619242591 |
| Entity Type | Organization |
| Organization Name | WILLAMETTE VALLEY ORAL & MAXILLOFACIAL SURGERY, INC |
| Practice Address |
3996 Corredale Ct. S. Salem OR 97302 |
| Mailing Address |
3996 Corredale Ct S Salem OR 97302-9326 |
| Practice Telephone | 5035811999 |
| Practice Fax Number | 5035811107 |
| Mailing Telephone | 5035811999 |
| Mailing Fax Number | 5035811107 |
| Enumeration Date | 2012-03-12 |
| Last Update Date | 2012-03-12 |
| Authorized Official Name | HOLLY JAYNE EYRE (OFFICE MANAGER) |
| Authorized Official Telephone | 5035811999 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | WILLAMETTE VALLEY ORAL & MAXILLOFACIAL SURGERY, INC. | 250 Church St Se Ste 102, Salem, OR 97301 |
| Street Address |
3996 CORREDALE CT. S. |
| City | SALEM |
| State | OR |
| Zip Code | 97302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952954679 | Eric Anthony Bohm | Pharmacist | 2757 22nd St. Se, Salem, OR 97302 | 2019-07-22 |
| 1598223737 | Michael Robert Martini | Counselor | 960 Liberty Rd Se Suite 120, Salem, OR 97302 | 2019-03-06 |
| 1659857480 | Avalina Pharmacy Inc | Pharmacy | 3507 Commercial St Se, Salem, OR 97302 | 2018-07-16 |
| 1649762733 | Joseph Bochsler | Physical Therapist | 3220 Liberty Rd. S., Salem, OR 97302 | 2018-06-04 |
| 1922533652 | Brianne Elizabeth Sischo | Licensed Practical Nurse | 3871 Fairview Industrial Dr. Se Ste, 150, Salem, OR 97302 | 2017-05-01 |
| 1851825566 | Modern Nose Clinic LLC | Otolaryngology | 340 Vista Ave Se, Ste 100, Salem, OR 97302 | 2017-04-19 |
| 1720529803 | Nicholas Forsberg | Massage Therapist | 126 Mize Rd S, Salem, OR 97302 | 2017-03-09 |
| 1437691078 | Kimo Mahi | Specialist/Technologist, Other | 2373 Kuebler Rd. S, Salem, OR 97302 | 2016-11-14 |
| 1588113278 | New Life Family Medicine LLC | Clinic/Center | 842 Commercial Street Ne, Salem, OR 97302 | 2016-09-23 |
| 1073060117 | Susan Morag Robnett | Counselor | 912 Fir Street South, Salem, OR 97302 | 2016-09-07 |
| Find all providers in zip 97302 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417940289 | Joel Kenneth Hopkin | Oral & Maxillofacial Surgery | 2266 Mission St Se, Salem, OR 97302-1267 | 2005-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124381629 | Sam Seoho Bae | Oral & Maxillofacial Surgery | 6464 Sw Borland Rd Ste D3, Tualatin, OR 97062 | 2012-06-19 |
| 1568605731 | Philip C Mann | Oral & Maxillofacial Surgery | 16455 Boones Ferry Rd Ste B, Lake Oswego, OR 97035-4367 | 2009-04-16 |
| 1821162595 | Daniel J Olson | Oral & Maxillofacial Surgery | 2510 Nw Medical Park Drive, Roseburg, OR 97470 | 2006-11-17 |
| 1952329450 | Timothy B Welch | Oral & Maxillofacial Surgery | 911 Country Club Rd Ste 100, Eugene, OR 97401-6045 | 2006-07-17 |
| 1346249281 | Bryce Earl Potter | Oral & Maxillofacial Surgery | 1849 Nw Kearney St, Ste 300, Portland, OR 97209-1453 | 2005-07-20 |
| 1932611696 | Philip C. Mann, Dds, Md, LLC | Oral & Maxillofacial Surgery | 16455 Boones Ferry Rd Ste B, Lake Oswego, OR 97035-4367 | 2017-11-02 |
| 1053864561 | Karl Cuddy | Oral & Maxillofacial Surgery | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2016-08-01 |
| 1104209386 | Felix Wiyanto Sim | Oral & Maxillofacial Surgery | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2015-07-07 |
| 1407109937 | Providence Health & Services - Oregon | Oral & Maxillofacial Surgery | 4805 Ne Glisan St, Suite 6n50, Portland, OR 97213-2933 | 2012-10-22 |
| 1447525852 | Brett A. Ueeck Dmd, Md, PC | Oral & Maxillofacial Surgery | 11786 Sw Barnes Rd Ste 110, Portland, OR 97225-5926 | 2012-03-19 |
| 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.