JEREMY RYAN VISTICA (NPI# 1639368582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639368582 |
| Entity Type | Individual |
| Full Name | JEREMY RYAN VISTICA |
| Credential | DMD |
| Practice Address |
200 Gwee Shut Rd Siletz OR 97380-2036 |
| Mailing Address |
Po Box 320 Siletz OR 97380-0320 |
| Practice Telephone | 5414441030 |
| Practice Fax Number | 5414449678 |
| Mailing Telephone | 5414441030 |
| Mailing Fax Number | 5414449678 |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2017-02-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D8993 | OR | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500637605 | 05 |
| Street Address |
200 GWEE SHUT RD |
| City | SILETZ |
| State | OR |
| Zip Code | 97380-2036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043817166 | Christopher Ray Oleman | Peer Specialist | 200 Gwee Shut Rd, Siletz, OR 97380-2036 | 2020-10-01 |
| 1396351920 | Dee Butler | Counselor | 200 Gwee Shut Rd, Siletz, OR 97380-2036 | 2020-09-18 |
| 1083249056 | Francisca Darlene Rilatos | Community Health Worker | 200 Gwee Shut Rd, Siletz, OR 97380-2036 | 2020-03-10 |
| 1902441561 | Corey Wayne Strong | Community/Behavioral Health | 200 Gwee Shut Rd, Siletz, OR 97380-2036 | 2019-11-07 |
| 1730643883 | Amy Gean Garrett | Community Health Worker | 200 Gwee Shut Rd, Siletz, OR 97380-2036 | 2019-01-23 |
| 1548733207 | Elizabeth Stam | Massage Therapist | 200 Gwee Shut Rd, Siletz, OR 97380-2036 | 2019-01-05 |
| 1801379144 | Teresa Francine Carpenter | Dental Hygienist | 200 Gwee Shut Rd, Siletz, OR 97380-2036 | 2018-09-12 |
| 1518456060 | Ashliegh Victoria Ramirez | Counselor | 200 Gwee Shut Rd, Siletz, OR 97380-2036 | 2018-05-09 |
| 1154837383 | Confederated Tribes of Siletz | Pharmacy | 200 Gwee Shut Rd, Siletz, OR 97380-2036 | 2017-12-26 |
| 1083123681 | Danielle Shaunte Payne | Counselor | 200 Gwee Shut Rd, Siletz, OR 97380-2036 | 2017-09-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740408525 | Mary Ellen Volansky | Dental Hygienist | 107 Se Swan Avenue, Ctsi Dental Clinic, Siletz, OR 97380 | 2007-04-24 |
| 1023131646 | Conrad M Douma Jr. | Counselor | 107 Se Swan, Siletz, OR 97380 | 2007-04-09 |
| 1790888097 | Beverley E Phillipson | Internal Medicine | 107 Se Swan Ave, Siletz, OR 97380 | 2006-09-06 |
| 1952403990 | Lisa D Taylor | Registered Nurse | 200 Gwee-shut Road, Siletz, OR 97380 | 2006-09-01 |
| 1083966329 | Lorene Stanger | Optometrist | 200 Gwee-shut Rd, Optometry, Siletz, OR 97380 | 2012-10-10 |
| 1427345826 | Delina Lynn John | Counselor | 200 Gwee-shut Road, Siletz, OR 97380 | 2011-07-06 |
| 1508196718 | Timothy W. Henkels | Nurse Practitioner | 200 Gwee Shut Road, Siletz, OR 97380 | 2010-01-11 |
| 1477747095 | Molly M Francis | Dentist | 107 Se Swan, Siletz, OR 97380 | 2007-08-28 |
| 1033324264 | James Peirce Haeg | Family Medicine | 107 Se Swan Ave, Siletz, OR 97380 | 2007-05-11 |
| 1477676088 | Janet Wicklund | Counselor | 107 Se Swan, Siletz, OR 97380 | 2007-04-09 |
| Find all providers in zip 97380 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477747095 | Molly M Francis | Dentist | 107 Se Swan, Siletz, OR 97380 | 2007-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518573237 | Ishpreet Kaur | Dentist | 1759 N Riverside Ave, Medford, OR 97501-4628 | 2020-09-17 |
| 1336754456 | Springfield Dental Partners LLC | Dentist | 498 Harlow Rd Ste 2, Springfield, OR 97477-1339 | 2020-09-15 |
| 1790390060 | Tyler Joseph Craven | Dentist | 4515 Se Harrison St, Milwaukie, OR 97222-5221 | 2020-09-13 |
| 1972117588 | Medical Teams International | Dentist | 14150 Sw Milton Ct, Portland, OR 97224-8024 | 2020-09-01 |
| 1184238727 | Hayden Alexander Meriwether | Dentist | 17895 Ne Evergreen Pkwy, #100, Beaverton, OR 97006 | 2020-09-01 |
| 1801400684 | Michael Carreon | Dentist | 1332 Sw Highland Ave, Redmond, OR 97756-2640 | 2020-08-31 |
| 1679196190 | Members Plus Dental | Dentist | 156 Catron St N, Monmouth, OR 97361-2303 | 2020-05-19 |
| 1265054175 | Members Plus Dental, LLC | Dentist | 2220 9th Ave Se Ste B, Albany, OR 97322-5000 | 2020-05-13 |
| 1619504164 | Anna Nicole Gerlach | Dentist | 1915 Ne Baker St, Mcminnville, OR 97128-2601 | 2020-03-25 |
| 1598391054 | Slater Family Dental, PC | Dentist | 18540 Sw Vincent, Aloha, OR 97078 | 2020-03-17 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on JEREMY RYAN VISTICA.
| 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.