COBURN DENTAL OFFICE LLC (NPI# 1770831539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770831539 |
| Entity Type | Organization |
| Organization Name | COBURN DENTAL OFFICE LLC |
| Other Organization Name | SANDCREEK FAMILY DENTISTRY |
| Practice Address |
116 N Meade Ave Glendive MT 59330-1604 |
| Practice Telephone | 4063778265 |
| Practice Fax Number | 4063778267 |
| Mailing Telephone | 4063778265 |
| Mailing Fax Number | 4063778267 |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2015-11-23 |
| Authorized Official Name | DR. RICHARD RYAN COBURN (OWNER) |
| Authorized Official Telephone | 4063778265 |
| Authorized Official Credential | D.M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
2288 | MT | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Sandcreek Family Dentistry | Doing Business As Name - Organization |
| Street Address |
116 N MEADE AVE |
| City | GLENDIVE |
| State | MT |
| Zip Code | 59330-1604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124186358 | George R. Carson D.d.s. P.C. | Dentist | 116 N Meade Ave, Glendive, MT 59330-1631 | 2006-12-04 |
| 1972030708 | Calkins Dental Office, LLC | Clinic/Center | 116 N Meade Ave, Glendive, MT 59330-1604 | 2017-05-11 |
| 1598177115 | Matthew Don Calkins | Dentist | 116 N Meade Ave, Glendive, MT 59330-1604 | 2014-06-02 |
| 1134377732 | George R Carson | Dentist | 116 N Meade Ave, Glendive, MT 59330-1631 | 2008-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003312224 | Ashley Grammens | Pharmacist | 307 Harmon Street, Glendive, MT 59330 | 2018-04-05 |
| 1154651016 | Debra Linn | Speech-Language Pathologist | 14 Big Sky Drive, Glendive, MT 59330 | 2009-12-28 |
| 1790293116 | Jessica Marie Domire | Nurse Practitioner | 202 Prospect Dr, Glendive, MT 59330 | 2018-01-19 |
| 1770965972 | Nena Panasuk | Family Medicine | 107 Dilworth St, Glendive, MT 59330 | 2015-06-24 |
| 1891938882 | Monica M Melchior | Social Worker | 807 Clark Ave, Glendive, MT 59330-1400 | 2009-04-07 |
| 1275593410 | Ft Reynolds | Pharmacy | 1014 W Bell St, Glendive, MT 59330-1502 | 2006-03-23 |
| 1346296266 | Albertsons LLC | Durable Medical Equipment & Medical Supplies | 307 Harmon St, Glendive, MT 59330-1510 | 2006-05-25 |
| 1275870909 | Steve Knoop | Pharmacist | 307 Harmon St, Glendive, MT 59330-1510 | 2013-01-15 |
| 1134254873 | City of Glendive | Ambulance | 300 S Merrill Ave, Glendive, MT 59330-1610 | 2007-02-22 |
| 1447353008 | County of Dawson | Public Health or Welfare | 207 W Bell St, Glendive, MT 59330-1616 | 2006-09-07 |
| Find all providers in zip 59330 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972030708 | Calkins Dental Office, LLC | Clinic/Center | 116 N Meade Ave, Glendive, MT 59330-1604 | 2017-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265050439 | Diggs Dental Care | Clinic/Center | 1547 S Higgins Ave Ste 103, Missoula, MT 59801-4226 | 2020-07-14 |
| 1750905063 | Glacier Valley Endodontics | Clinic/Center | 80 Four Mile Dr Ste 15, Kalispell, MT 59901-2665 | 2020-06-02 |
| 1558909093 | Mountain Shore Pllc | Clinic/Center | 50113 Us Highway 93, Polson, MT 59860-7035 | 2019-12-16 |
| 1922662840 | Smile Care Pllc | Clinic/Center | 14555 Hellgate Ln, Clinton, MT 59825-9715 | 2019-04-25 |
| 1427551464 | Dr Mark A Vanzant Pllc | Clinic/Center | 203 Business Center Loop Ste C, Kalispell, MT 59901-6885 | 2018-03-15 |
| 1831601483 | Murdock Family Dentistry | Clinic/Center | 926 Main St Ste 1, Billings, MT 59105-3359 | 2017-11-03 |
| 1861933632 | Wojj Pediatric Dentistry | Clinic/Center | 115 W Kagy Blvd Ste C, Bozeman, MT 59715-6030 | 2017-03-14 |
| 1265895999 | Budde Family Dentistry | Clinic/Center | 120 1st Street North, Glasgow, MT 59230 | 2016-03-31 |
| 1013378462 | Scobey Dental Inc. | Clinic/Center | 504 Timmons Street, Scobey, MT 59263 | 2016-03-14 |
| 1437595725 | Partnership Health Center Inc | Clinic/Center | 1150 Sherwood St, Missoula, MT 59802 | 2013-05-14 |
| 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.