1. Home
  2. Directory
  3. Oregon
  4. Prineville
  5. Clinic Center
  6. NPI Profile

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: August 16, 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
Open in Google Maps ↗

Other Names 1

Doing Business AsMosaic Medical Prineville Dental

Other Identifiers 1

Medicaid182960OR

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. LINDA HATCH FNP
Nurse Practitioner (Family)
375 NW BEAVER ST
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
KAREN YEARGAIN LPN
Licensed Practical Nurse
375 NW BEAVER ST, STE 100
PRINEVILLE, OR 97754
Crook County (541) 447-5165
JENNIFER DAMORE NP
Nurse Practitioner (Women's Health)
375 NW BEAVER ST, SUITE 100
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
NELDA J GRYMES RN
Registered Nurse
375 NW BEAVER ST, STE. 100
PRINEVILLE, OR 97754
Crook County (541) 447-5165
WENDY PERRIN RN
Registered Nurse (Community Health)
375 NW BEAVER ST
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

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 Mosaic Medical Dental's NPI number?

The NPI number for Mosaic Medical Dental is 1174066963. It was assigned to this organization in the NPPES registry on November 28, 2016. The provider is doing business as Mosaic Medical Prineville Dental.

Where is Mosaic Medical Dental located?

Mosaic Medical Dental is located at 375 NW Beaver St Suite 101, Prineville, OR 97754. The listed phone number is (541) 447-0707.

What is Mosaic Medical Dental's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

When was this NPI record last updated?

The NPPES record for Mosaic Medical Dental was last updated on February 28, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.