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NPI Code Detail

MEDICARE: IOANE OFISA DDS

MEDICARE: IOANE OFISA DDS
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
11223G0001XGeneral Practice DentistryD8807OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225049562
Entity Type Code : Individual
Provider Name (Legal Business Name) : IOANE OFISA DDS
Provider Business Mailing Address
First Line : PO BOX 490
Second Line :
City : REDMOND
State : OR
Zip : 97756-0092
Country : US
Telephone Number : 888-468-0022
Fax Number : 541-504-3907
Provider Business Practice Location Address
First Line : 1880 LANCASTER DR NE STE 121
Second Line :
City : SALEM
State : OR
Zip : 97305-1069
Country : US
Telephone Number : 888-468-0022
Fax Number : 541-504-3907
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2006
Last Update Date : 10/03/2011

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Directions to “ IOANE OFISA DDS” Practice Location

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