Healthcare Provider Details

I. General information

NPI: 1649106345
Provider Name (Legal Business Name): MEGAN FAIRCHILD RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25078 E HUNTER RD
VENETA OR
97487-9601
US

IV. Provider business mailing address

90011 SHEFFLER RD
ELMIRA OR
97437-9771
US

V. Phone/Fax

Practice location:
  • Phone: 541-935-2113
  • Fax:
Mailing address:
  • Phone: 541-915-9541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberH6528
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: