is a Pediatric Dental Clinic in Bend, Oregon. It is located at 572 Sw Bluff Dr, Ste A, Bend, OR and its contact number is 541-318-5688. The authorized person for is Dr. Rex Shannon Gibson
who is Owner of the clinic and their contact number is 541-318-5688. The primary license number for is D7724 (Pediatric Dentistry) in Oregon. Clinic provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Complete Clinic Profile:
Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Specialization:
Pediatric Dentistry
Clinic Address:
572 Sw Bluff Dr, Ste A, Bend, Oregon, 97702-1260
Phone:
541-318-5688
Fax:
541-322-5581
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Dr. Rex Shannon Gibson
Position:
Owner
Contact Number:
541-318-5688
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for clinic are as mentioned below.
NPI Number:
1992706055
NPI Enumeration Date:
10 Aug, 2005
NPI Last Update On:
22 Aug, 2020
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for are as mentioned below.
Specialization
License Number
State
Status
Pediatric Dentistry
D7724
Oregon
Primary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
299183
Medicaid
Oregon
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
572 Sw Bluff Dr, Ste A Bend, Oregon
Zip:
97702-1260
Phone Number:
541-318-5688
Fax Number:
541-322-5581
Patients can reach at 572 Sw Bluff Dr, Ste A, Bend, Oregon or can call to book an appointment on 541-318-5688. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 10 February, 2025.