ADVANTAGE DENTAL GROUP, PC (NPI# 1831741958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831741958 |
| Entity Type | Organization |
| Organization Name | ADVANTAGE DENTAL GROUP, PC |
| Practice Address |
300 Tatone Boardman OR 97818 |
| Mailing Address |
Po Box 11470 Eugene OR 97440-3670 |
| Practice Telephone | 5419454008 |
| Practice Fax Number | 5415164041 |
| Mailing Telephone | 5419454008 |
| Mailing Fax Number | 5415164041 |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2019-07-09 |
| Authorized Official Name | JENELL STUMP (MANAGER, LICENSING & CREDENTIALING) |
| Authorized Official Telephone | 6299995006 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500694102 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447812813 | Advantage Dental Group, PC | Dentist | 1275 Oregon Ave Se, Bandon, OR 97411-9102 | 2019-07-05 |
| 1972970671 | Advantage Dental Group, PC | Dentist | 442 Sw Umatilla Ave Ste 200, Redmond, OR 97756-7039 | 2015-08-28 |
| Street Address |
300 TATONE |
| City | BOARDMAN |
| State | OR |
| Zip Code | 97818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548485865 | Hayden Family Dentistry Group | Dentist | 300 Tatone, Boardman, OR 97818 | 2007-04-13 |
| 1962801084 | Rose Greyslak | Dentist | 300 Tatone, Boardman, OR 97818-9999 | 2014-08-14 |
| 1578810404 | Tyler Bendixsen | Dentist | 300 Tatone, Boardman, OR 97818 | 2012-08-09 |
| 1770861791 | Jeremy Larson | Dentist | 300 Tatone, Boardman, OR 97818 | 2011-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477178721 | Kaelyn Rose Lindsay | Counselor | 104 Sw Kinkade Ave., Boardman, OR 97818 | 2020-06-12 |
| 1225674807 | Jose James Ortiz Jr. | Counselor | 104 Kinkade Ave, Boardman, OR 97818 | 2019-11-19 |
| 1982149647 | Kymberli Dawn Erevia | Specialist | 104 S. W. Kinkade Road, Boardman, OR 97818 | 2017-01-04 |
| 1194277814 | Scott R Ruch | Community/Behavioral Health | 104 Sw. Kinkade Rd, Boardman, OR 97818 | 2016-10-28 |
| 1144660168 | Cydney M. Morgan | Counselor | 103 Sw Kinkade Rd., Boardman, OR 97818 | 2013-07-05 |
| 1801151121 | Mayra Colin Carrillo | Counselor | 104 S.w. Kinkade Rd., Boardman, OR 97818 | 2012-07-12 |
| 1306103429 | Good Shepherd Medical Service Corp | Pharmacy | 220 S. Main, Boardman, OR 97818 | 2012-04-13 |
| 1437359387 | Emily Dawn Reynolds | Counselor | 104 Sw Kinkade Road, Boardman, OR 97818 | 2007-07-19 |
| 1336294057 | Brandi Nichole Pollick | Counselor | 101 Nw Boardman Ave, Boardman, OR 97818 | 2007-01-24 |
| 1346300159 | Boardman Hardware Inc | Pharmacy | 202 N.w. First, Boardman, OR 97818 | 2006-12-11 |
| Find all providers in zip 97818 | ||||
| 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 |
|---|---|---|---|---|
| 1780283556 | Ziyad Amir Kadir | Dentist | 300 Tatone St, Boardman, OR 97818-7900 | 2020-10-22 |
| 1083941314 | Melissa Mullane Padgett, Dds, LLC | Dentist | 1006 Boardman Canfield Rd, Suite 1a, Boardman, OH 44512-4278 | 2009-11-06 |
| 1861605677 | Michael H Leone | Dentist | 825 Kentwood Drive, Boardman, OH 44512 | 2007-05-08 |
| 1548485865 | Hayden Family Dentistry Group | Dentist | 300 Tatone, Boardman, OR 97818 | 2007-04-13 |
| 1154462695 | Robert D Perrott | Dentist | 7200 Bristlewood Dr, Boardman, OH 44512-5111 | 2007-02-09 |
| 1730254129 | Raymond Feudo | Dentist | 930 Boardman Portland Road Route 224, Boardman, OH 44512 | 2006-11-21 |
| 1508940446 | Melissa Padgett | Dentist | 1006 Boardman-canfield Rd., Suite 1-a, Boardman, OH 44512 | 2006-10-25 |
| 1225001241 | James M Gentile | Dentist | 6540 South Ave, Suite B, Boardman, OH 44512-3651 | 2006-02-09 |
| 1982685855 | Joseph A Mika | Dentist | 5815 Market St Ste 6, Boardman, OH 44512-2915 | 2005-11-08 |
| 1497248736 | Hanjun Guan | Dentist | 6540 South Ave, Boardman, OH 44512-3651 | 2018-06-12 |
| Find all providers in BOARDMAN | ||||
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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.