MID-VALLEY DENTAL OF PHILOMATH (NPI# 1760582985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760582985 |
| Entity Type | Organization |
| Organization Name | MID-VALLEY DENTAL OF PHILOMATH |
| Other Organization Name | MID-VALLEY DENTAL ARTS |
| Practice Address |
2811 Main St Philomath OR 97370 |
| Practice Telephone | 5419295227 |
| Practice Fax Number | 5419297649 |
| Mailing Telephone | 5419295227 |
| Mailing Fax Number | 5419297649 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2016-12-19 |
| Authorized Official Name | GEOFFREY A BERG (DENTIST/OWNER) |
| Authorized Official Telephone | 5419282301 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D7915 | OR | Dental Providers |
| Other Name | Type Code |
|---|---|
| Mid-Valley Dental Arts | Former Legal Business Name - Organization |
| Street Address |
2811 MAIN ST |
| City | PHILOMATH |
| State | OR |
| Zip Code | 97370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649756156 | Dorie J Jackson | Dental Hygienist | 2811 Main St, Philomath, OR 97370-9245 | 2018-07-17 |
| 1740632488 | Taylor Bennion | Dentist | 2811 Main St, Philomath, OR 97370-9245 | 2016-07-06 |
| 1194176016 | Mid-valley Dental Associates | Dentist | 2811 Main St, Philomath, OR 97370-9245 | 2016-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255850889 | Philomath Counseling, LLC | Social Worker | 1229 Main St. #105, Philomath, OR 97370 | 2017-09-14 |
| 1548634934 | Pamela Versage | Physical Therapist | 111 North 20th, Philomath, OR 97370 | 2015-11-23 |
| 1588966402 | Aimee Lynn Lesieutre | Acupuncturist | 113 S. 10th St., Philomath, OR 97370 | 2010-11-29 |
| 1720397201 | Ronnie Louise Hansen | Social Worker | 1229 Main Street, Philomath, OR 97370 | 2010-09-30 |
| 1669799029 | Rebecca Bricker | Registered Nurse | 506 S. 19th Street, Philomath, OR 97370 | 2010-04-26 |
| 1457686073 | Raina Wickham | Counselor | 1229 Main Street, Suite 105, Philomath, OR 97370 | 2009-10-15 |
| 1386846038 | Rebecca D Anderson | Counselor | 1215 Main Street, Philomath, OR 97370 | 2007-06-04 |
| 1447376314 | Pediatric Therapy Professionals Inc | Clinic/Center | 111 Ne 20th St, Philomath, OR 97370 | 2007-03-22 |
| 1437201357 | Phoenix Ries | Counselor | 1322 Main St., Philomath, OR 97370 | 2007-01-18 |
| 1073699930 | Gretchen Landis | Acupuncturist | 1332 Main St., Philomath, OR 97370 | 2006-10-31 |
| Find all providers in zip 97370 | ||||
| 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 |
|---|---|---|---|---|
| 1649471665 | Daniel Paul Rooke | Dentist | 1224 Applegate St, Philomath, OR 97370-0000 | 2007-05-29 |
| 1740632488 | Taylor Bennion | Dentist | 2811 Main St, Philomath, OR 97370-9245 | 2016-07-06 |
| 1194176016 | Mid-valley Dental Associates | Dentist | 2811 Main St, Philomath, OR 97370-9245 | 2016-06-22 |
| 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 | ||||
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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.