MEDICARE: WILLAMETTE VALLEY ORAL & MAXILLOFACIAL SURGEY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	D6858	OR

General Provider Information

NPI Number	:	1144575267
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLAMETTE VALLEY ORAL & MAXILLOFACIAL SURGEY, INC.

Provider Business Mailing Address
First Line	:	250 CHURCH ST SE STE 102
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97301-3758
Country	:	US
Telephone Number	:	503-581-1999
Fax Number	:	503-581-1107

Provider Business Practice Location Address
First Line	:	250 CHURCH ST SE STE 102
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97301-3758
Country	:	US
Telephone Number	:	503-581-1999
Fax Number	:	503-581-1107

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	HOLLY J EYRE
Credential	:
Telephone Number	:	503-581-1999

Provider Enumeration Date	:	07/15/2012
Last Update Date	:	07/15/2012

Similar Medicare Providers

1518452705 — DR. YISI DAISY JI MD, DMD
Practice Location Address:

250 CHURCH ST SE STE 102
SALEM, OR
97301-3758

Practice Phone: 503-581-1999
Practice Fax:

1093335929 — STERLING RECOVERY, LLC
Practice Location Address:

3758 AMBER ST NE #105
SALEM, OR
97301

Practice Phone: 971-273-8668
Practice Fax: 833-390-2537

1053066894 — OR SPECIALTY DENTAL SERVICES LLC
Practice Location Address:

250 CHURCH ST SE STE 102
SALEM, OR
97301-3758

Practice Phone: 503-581-1999
Practice Fax:

1568339711 — OR OMS SPECIALTY DENTAL SERVICES, LLC
Practice Location Address:

250 CHURCH ST SE STE 102
SALEM, OR
97301-3758

Practice Phone: 503-581-1999
Practice Fax: 503-581-1107

1548137706 — OR OMS SPECIALTY DENTAL SERVICES, LLC
Practice Location Address:

250 CHURCH ST SE STE 102
SALEM, OR
97301-3758

Practice Phone: 503-581-1999
Practice Fax:

1639363401 — JESSICA SMITH FNP
Practice Location Address:

15 E CLAY ST
SALEM, VA
24153-3758

Practice Phone: 540-378-0190
Practice Fax: 540-387-0584

Directions to “WILLAMETTE VALLEY ORAL & MAXILLOFACIAL SURGEY, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.