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DR. IVAN DASSENKO MD
NPI 1104028364
General Practice in Salem, OR

Active since June 01, 2007
6810 CANYON ST SE, SALEM, OR 97317(503) 581-7379(503) 585-7816 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Ivan Dassenko Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. IVAN DASSENKO MD (NPI 1104028364) is an individual general practice provider in Salem, Oregon, licensed in Oregon (6160) and active in the NPI registry since June 2007.

NPPES Registry Identity

NPI1104028364
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameDR. IVAN DASSENKOCredential: MD
Location Address6810 CANYON ST SESalem, OR 97317-9024
Mailing Address6810 Canyon St SeSalem, OR 97317-9024 · (503) 581-7379 · Fax (503) 585-7816
Phone(503) 581-7379
Fax(503) 585-7816
Sole ProprietorNo
Enumeration DateJune 1, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1104028364 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in OR · 6160
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
6810 CANYON ST SE, Salem, OR 97317
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Other Identifiers 2

Medicare UPINC92478
Medicare ID-Type UnspecifiedBGTVOR

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ivan Dassenko's NPI number?

The NPI number for Ivan Dassenko is 1104028364. It was assigned to this individual provider in the NPPES registry on June 1, 2007.

Where is Ivan Dassenko located?

Ivan Dassenko practices at 6810 Canyon St SE, Salem, OR 97317. The listed phone number is (503) 581-7379.

What is Ivan Dassenko's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Ivan Dassenko was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.