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MOSAIC MEDICAL PRINEVILLE DENTAL
NPI 1174066963
Clinic/Center - Federally Qualified Health Center (FQHC) in Prineville, OR

Active since November 28, 2016
375 NW BEAVER ST, SUITE 101, PRINEVILLE, OR 97754(541) 447-0707(541) 383-1883 Get Directions Write a Review

NPPES record last updated: February 28, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mosaic Medical Prineville Dental NPPES

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

MOSAIC MEDICAL PRINEVILLE DENTAL (NPI 1174066963) is a healthcare organization registered as a federally qualified health center (fqhc) in Prineville, Oregon and active in the NPI registry since November 2016. The organization lists Megan Haase, Ceo, as its authorized official.

NPPES Registry Identity

NPI1174066963
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameMOSAIC MEDICAL DENTAL
Location Address375 NW BEAVER ST, SUITE 101Prineville, OR 97754-1802
Mailing Address600 Sw Columbia St, Suite 6210Bend, OR 97702-1099 · (541) 383-3005
Phone(541) 447-0707
Fax(541) 383-1883
Organization SubpartYesParent: Mosaic Medical
Authorized OfficialMegan HaaseCeo · (541) 447-0707
Enumeration DateNovember 28, 2016
Last NPPES UpdateFebruary 28, 2018
✔ NPI 1174066963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedClinic/Center · DentalTaxonomy 261QD0000X
375 NW BEAVER ST, Prineville, OR 97754
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Other Names 1

Doing Business AsMosaic Medical Prineville Dental

Other Identifiers 1

Medicaid182960OR

Other Providers at the Same Location


The following 16 providers are registered at the same or a nearby location.

COUNTY OF CROOK
Clinic/Center (Public Health, Federal)
375 NW BEAVER ST, SUITE 100
PRINEVILLE, OR 97754
Crook County (541) 447-5165
NELDA J GRYMES RN
Registered Nurse
375 NW BEAVER ST, STE. 100
PRINEVILLE, OR 97754
Crook County (541) 447-5165
MURIEL MARGARET DELAVERGNE-BROWN R.N.
Registered Nurse (Administrator)
375 NW BEAVER ST, STE. 100
PRINEVILLE, OR 97754
Crook County (541) 447-5165
KAREN YEARGAIN LPN
Licensed Practical Nurse
375 NW BEAVER ST, STE 100
PRINEVILLE, OR 97754
Crook County (541) 447-5165
PAULA YVONNE RN, BSN
Registered Nurse (Community Health)
375 NW BEAVER ST, SUITE 100
PRINEVILLE, OR 97754
Crook County (541) 447-5165
LEAH FLEGEL RN
Registered Nurse
375 NW BEAVER ST, #100
PRINEVILLE, OR 97754
Crook County (541) 447-5165
KATRINA SIMPSON RN
Registered Nurse (Community Health)
375 NW BEAVER ST
PRINEVILLE, OR 97754
Crook County (541) 447-5165
MOSAIC MEDICAL
Clinic/Center (Federally Qualified Health Center (FQHC))
375 NW BEAVER ST, SUITE 101
PRINEVILLE, OR 97754
Crook County (541) 447-0707
JENNIFER DAMORE NP
Nurse Practitioner (Women's Health)
375 NW BEAVER ST, SUITE 100
PRINEVILLE, OR 97754
Crook County (541) 447-5165
MEGANN DASTRUP MDA
Dietitian, Registered
375 NW BEAVER ST, SUITE 101
PRINEVILLE, OR 97754
Crook County (541) 447-0707
REBECCA G. LUNDGREN RN
Registered Nurse
375 NW BEAVER ST, SUITE 101
PRINEVILLE, OR 97754
Crook County (541) 447-0707
WENDY PERRIN RN
Registered Nurse (Community Health)
375 NW BEAVER ST
PRINEVILLE, OR 97754
Crook County (541) 447-5165
SUSAN PUDDY RN
Registered Nurse (General Practice)
375 NW BEAVER ST
PRINEVILLE, OR 97754
Crook County (541) 447-5165
MS. LINDA HATCH FNP
Nurse Practitioner (Family)
375 NW BEAVER ST
PRINEVILLE, OR 97754
Crook County (541) 447-0707
DR. CHARLES ALBERT NOYES PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
375 NW BEAVER ST, SUITE 101
PRINEVILLE, OR 97754
Crook County (541) 447-0707
LEEANN CHERYL OSBORNE PA
Physician Assistant (Medical)
375 NW BEAVER ST, SUITE 101
PRINEVILLE, OR 97754
Crook County (541) 447-1680

Frequently Asked Questions

What is MOSAIC MEDICAL DENTAL's NPI number?

The NPI number assigned to this healthcare provider is 1174066963, enumerated as an "organization" on November 28, 2016.

Where is the provider located?

The provider is located at 375 NW BEAVER ST SUITE 101 PRINEVILLE, OR 97754 and the phone number is (541) 447-0707.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).

What insurance does MOSAIC MEDICAL DENTAL accept?

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.