MID-VALLEY DENTAL ASSOCIATES, LLC (NPI# 1700029709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700029709 |
| Entity Type | Organization |
| Organization Name | MID-VALLEY DENTAL ASSOCIATES, LLC |
| Practice Address |
2825 Willetta St Sw Suite A Albany OR 97321-3846 |
| Practice Telephone | 5419282301 |
| Practice Fax Number | 5419288493 |
| Mailing Telephone | 5419282301 |
| Mailing Fax Number | 5419288493 |
| Enumeration Date | 2009-04-07 |
| Last Update Date | 2009-04-07 |
| Authorized Official Name | SUSAN M. BAHAM (OFFICE MANAGER) |
| Authorized Official Telephone | 5419282301 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
D8673 | OR | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
D9084 | OR | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
D9107 | OR | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D7915 | OR | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700165362 | Mid-valley Dental Associates, LLC | Dentist | 3385 Center St Ne, Salem, OR 97301-4609 | 2011-08-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | MID-VALLEY DENTAL ASSOCIATES, LLC | 2825 Sw Willetta St, Albany, OR 97321 |
| Street Address |
2825 WILLETTA ST SW SUITE A |
| City | ALBANY |
| State | OR |
| Zip Code | 97321-3846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841286655 | Geoffrey A Berg | Dentist | 2825 Willetta St Sw, Ste A, Albany, OR 97321-3846 | 2005-09-27 |
| 1124686068 | Daniel Halsey Reynolds | Dentist | 2825 Willetta St Sw, Albany, OR 97321-3846 | 2019-06-05 |
| 1922260595 | Steven Michael Deming | Dentist | 2825 Willetta St Sw, Suite A, Albany, OR 97321-3846 | 2008-06-25 |
| 1962623603 | Tyler Lee Bryan | Dentist | 2825 Willetta St Sw, Suite A, Albany, OR 97321-3846 | 2007-05-01 |
| 1265469423 | John L. Lear-konold | Physical Therapist | 2825 Willetta St Sw, Suite B, Albany, OR 97321-3846 | 2006-06-26 |
| 1578599593 | Christie L. Nyquist | Physical Therapist | 2825 Willetta St Sw, Suite B, Albany, OR 97321-3846 | 2006-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730659228 | Waverly Assisted Living, LLC | In Home Supportive Care | 2853 Salem Ave Se Ste A, Albany, OR 97321 | 2018-11-28 |
| 1558838706 | Greater Albany Public Schools 8j | Local Education Agency (LEA) | 718 Seventh Ave. Sw, Albany, OR 97321 | 2018-10-25 |
| 1396232237 | Chiho Sakamoto Gunton | Social Worker | 227 Sw 3rd Avenue, Albany, OR 97321 | 2018-04-17 |
| 1700333184 | Albany General Hospital | Clinic/Center | 534 Pleasant View Way Nw, Suite 400, Albany, OR 97321 | 2016-09-02 |
| 1811373772 | Katrin M Ridge | Pharmacist | 1010 7th Ave. Sw., Albany, OR 97321 | 2015-08-03 |
| 1720485527 | Heartsong Counseling | Counselor | 425 Sw 2nd Ave. #203, Albany, OR 97321 | 2014-11-24 |
| 1619386604 | Courtney Ann Miller | Dentist | 2815 Willetta St, Suite A-1, Albany, OR 97321 | 2014-08-05 |
| 1346664810 | Jeffrey Othniel Nordtvedt | Case Manager/Care Coordinator | 2730 Sw Pacific Boulevard, Albany, OR 97321 | 2014-02-05 |
| 1174872022 | Albany General Hospital | Internal Medicine | 631 Southwest Elm Street, Suite 200, Albany, OR 97321 | 2012-09-06 |
| 1144594532 | Russell Travis | Pharmacist | 1177 Waverly Dr, Albany, OR 97321 | 2012-03-02 |
| Find all providers in zip 97321 | ||||
| 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 |
|---|---|---|---|---|
| 1245860345 | Hickory St LLC | Dentist | 637 Hickory St Nw Ste 110, Albany, OR 97321-1761 | 2020-01-17 |
| 1851945372 | Alaine Tay Shomali Prevish | Dentist | 409 1st Ave Nw, Albany, OR 97321-2227 | 2019-08-01 |
| 1053971028 | Richard Randall Mcneely | Dentist | 1725 Dawson Rd, Albany, GA 31707-3362 | 2019-06-20 |
| 1417438102 | David Levine | Dentist | 888 Western Ave, Albany, NY 12203-2532 | 2018-08-22 |
| 1417440223 | Megan Raiber | Dentist | 360 Railroad Ave, Albany, MN 56307-6201 | 2018-06-07 |
| 1619386604 | Courtney Ann Miller | Dentist | 2815 Willetta St, Suite A-1, Albany, OR 97321 | 2014-08-05 |
| 1417290925 | Alexander Q Steres | Dentist | 1873 Western Ave Ste 200, Albany, NY 12203-5028 | 2013-04-03 |
| 1932447620 | Tina Jacob | Dentist | 5 Pine West Plz Ste 504, Albany, NY 12205-5587 | 2013-01-30 |
| 1669721452 | Centre' for Cosmetic Dentistry | Dentist | 2824 Gillionville Rd, Albany, GA 31721-2904 | 2012-09-07 |
| 1316222896 | Michael Jack Goger | Dentist | 1215 Hill St Se, Albany, OR 97322-3238 | 2011-10-17 |
| Find all providers in ALBANY | ||||
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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.