NPI 1003381914 · live from the CMS NPI Registry
Keyan Botsford, DMD, MSD
Dentist, Orthodontics and Dentofacial Orthopedics in Medford, OR. National Provider Identifier 1003381914, active.
NPI record
| NPI | 1003381914 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 1625 E Mcandrews Rd Ste B, Medford, OR 97504 |
| Practice phone | 541-779-3003 |
| Enumerated | October 6, 2018 |
| Last updated | August 14, 2019 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | D10917 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.