Jeremy Ryan Vistica in Woodburn - Dentist
Jeremy Ryan Vistica - NPI 1639368582
Jeremy Ryan Vistica is a Dentist in Woodburn, Oregon. Jeremy Ryan Vistica practices all healthcare services and medical treatments related to Dentist. The NPI Number for Jeremy Ryan Vistica is 1639368582. The last update date is 2023-07-07.
Jeremy Ryan Vistica's current location address is 12100 Monitor Mckee Rd Ne, Woodburn, Oregon. You can contact this provider via phone number 5037065944. The mailing address for Jeremy Ryan Vistica is 12100 Monitor Mckee Rd Ne, Woodburn, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jeremy Ryan Vistica |
|---|---|
| Address | 12100 Monitor Mckee Rd Ne, Woodburn, Oregon |
| Phone Number | 5037065944 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | DMD |
NPI Number Detail
| NPI Number | 1639368582 |
|---|---|
| Provider Enumeration Date | 2007-10-16 |
| Last Updated Date | 2023-07-07 |
Provider Mailing Address Detail
| Address | 12100 Monitor Mckee Rd Ne |
|---|---|
| City | Woodburn |
| State | Oregon (OR) |
| Post Code | 970719089 |
| Phone Number | 5037065944 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | D8993 |
|
Definition: 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: denti |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 500637605 | OR | -- |
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What is the unique identification code assigned to Jeremy Ryan Vistica by the Centers for Medicare & Medicaid Services?
The Jeremy Ryan Vistica has been issued the NPI (National Provider Identifier) 1639368582. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Jeremy Ryan Vistica is physically located?
The Jeremy Ryan Vistica is physically situated at the following address: 12100 Monitor Mckee Rd Ne, Woodburn, OR, 970719089.
What is the Jeremy Ryan Vistica's specialty and taxonomy code?
The Jeremy Ryan Vistica's specialty is Dentist, and the corresponding taxonomy code is 122300000X.
When did the Jeremy Ryan Vistica receive its 1639368582?
The Jeremy Ryan Vistica was issued its 1639368582 on 2007-10-16, which is the date when the organization was assigned this unique identifier.
As of what date were the Jeremy Ryan Vistica's details last updated?
The information pertaining to the Jeremy Ryan Vistica, including its address, specialty, and other details, was most recently updated on 2023-07-07.
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