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Contact Information

ADVANTAGE DENTAL GROUP, PC
1275 OREGON AVE SE
BANDON, OR97411-9102
 Phone: 541-551-4022
 Fax: 541-516-4058
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for ADVANTAGE DENTAL GROUP, PC

NPI # 1447812813
LBN Legal business name ADVANTAGE DENTAL GROUP, PC
Authorized official SHARON EDMONDSON - (MANGER, LICENSING & CREDENTIALING)
Entity Organization
Organization subpart 1 No
Enumeration date 07/05/2019
Last updated 10/25/2021 - About 5 years ago
Identifiers
OR Medicaid 500694195
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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