Siskiyou Community Health Center Dental Facility – Federally Qualified Health Center (FQHC), NPI 1205002136

Siskiyou Community Health Center Dental Facility is a healthcare provider. based in Grants pass, Oregon. specializing in Federally Qualified Health Center (FQHC). The organization holds a License No. H3448 (OR). The NPI Number for Siskiyou Community Health Center Dental Facility is 1205002136

Main info

Organization
Name
Siskiyou Community Health Center Dental Facility
NPI
1205002136
Phone
(541) 955-6053
Address
PO BOX 158
Authorized Official
RICHARD BOOTH CEO
Enumeration Date
30 April 2008
Last Update Date
6 October 2021
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience70
Completeness80
Years active:18State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Siskiyou Community Health Center Dental Facility

  • PO BOX 158

    GRANTS PASS, OR 975280012

    Phone: (541) 955-6053

    Fax: (541) 471-2024

    Type: Mailing

  • Northeast 6th Street, Grants Pass, Josephine County, Oregon, 97506, United States

    SUITE B

    GRANTS PASS, OR 975261298

    Phone: (541) 479-6393

    Fax: (541) 479-6489

    Type: Location

  • 1701 NW HAWTHORNE AVE

    GRANTS PASS, OR 975261051

    Phone: (541) 479-6393

    Fax: (541) 471-2024

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97528)

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Reviews

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Frequently asked questions

What number should I use to identify Siskiyou Community Health Center Dental Facility for billing?
Administrative and clinical systems typically use NPI 1205002136 for Siskiyou Community Health Center Dental Facility.
Is Siskiyou Community Health Center Dental Facility's NPI status active today?
Active status means Siskiyou Community Health Center Dental Facility's NPI record is not deactivated in the public file.
What does the directory say Siskiyou Community Health Center Dental Facility does?
Insurance directories may phrase it differently, but here Siskiyou Community Health Center Dental Facility maps to Federally Qualified Health Center (FQHC). Clinical services aligned with this taxonomy classification.
Is Siskiyou Community Health Center Dental Facility tied to Grants Pass, Oregon?
If you are local to Grants Pass, Oregon, Siskiyou Community Health Center Dental Facility may be relevant to your search.
Can I export Siskiyou Community Health Center Dental Facility's record?
You can download the official NPPES record; we summarize key fields for readability.

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