<Unavail>
LBN: Mosaic Medical Dental
<Unavail> is an health care organization with primary practice located at 375 Nw Beaver St Suite 101, Prineville OR 97754-1802. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Dental, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC). Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty.
Mosaic Medical Dental can be contacted via phone (541) 447-0707, or through Haase, Megan via phone (541) 447-0707.
Contact Information
Primary practice address
375 Nw Beaver St Suite 101
Prineville OR 97754-1802
Phone: (541) 447-0707
Fax: (541) 383-1883
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Dental | 261QD0000X | ||
| Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) | 261QF0400X |
Profile Details
| NPI number | 1174066963 |
|---|---|
| LBN Legal business name | Mosaic Medical Dental |
| DBA Doing business as | <Unavail> |
| Authorized official | Haase, Megan |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Nov 28th, 2016 |
| Last updated | Feb 28th, 2018 - about 8 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174066963 | NPPES |
| Oregon | MEDICAID | 182960 |
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