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DR. THOMAS A KOLODGE DDS, MD
NPI 1639299100
Oral & Maxillofacial Surgery in Mcminnville, OR

Active since March 30, 2007Opted out of Medicare · through Apr 23, 2027
1046 NE 3RD ST, MCMINNVILLE, OR 97128(503) 472-1468 Get Directions Write a Review

NPPES record last updated: August 12, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Thomas A Kolodge Dds, Md NPPES

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

DR. THOMAS A KOLODGE DDS, MD (NPI 1639299100) is an individual oral & maxillofacial surgery provider in Mcminnville, Oregon, licensed in Oregon (MD126317) and active in the NPI registry since March 2007. He has opted out of Medicare through April 23, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1639299100
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameDR. THOMAS A KOLODGECredential: DDS, MD
Location Address1046 NE 3RD STMcminnville, OR 97128-4418
Mailing Address1046 Ne 3rd StMcminnville, OR 97128-4418 · (503) 472-1468
Phone(503) 472-1468
Sole ProprietorYes
Enumeration DateMarch 30, 2007
Last NPPES UpdateAugust 12, 2016
✔ NPI 1639299100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in OR · MD126317
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
Also ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X · License D9272 (OR)
1046 NE 3RD ST, Mcminnville, OR 97128
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Dr. Thomas A Kolodge Dds, Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 23, 2019 through April 23, 2027.

Opt-Out Effective DateApril 23, 2019
Opt-Out In Effect ThroughApril 23, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 3

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

DR. MARVIN JOHN JOHNSON DMD
Dentist (Oral and Maxillofacial Surgery)
1046 NE 3RD ST
MCMINNVILLE, OR 97128
Yamhill County (503) 472-1468
MOUNTAIN VIEW ORAL SURGERY AND DENTAL IMPLANTS
Dentist (Oral and Maxillofacial Surgery)
1046 NE 3RD ST
MCMINNVILLE, OR 97128
Yamhill County (503) 472-1468
BOONYAPA PURT DMD
Dentist (Oral and Maxillofacial Surgery)
1046 NE 3RD ST
MCMINNVILLE, OR 97128
Yamhill County (503) 472-1468

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 Thomas Kolodge's NPI number?

The NPI number for Thomas Kolodge is 1639299100. It was assigned to this individual provider in the NPPES registry on March 30, 2007.

Where is Thomas Kolodge located?

Thomas Kolodge practices at 1046 NE 3rd St, Mcminnville, OR 97128. The listed phone number is (503) 472-1468.

What is Thomas Kolodge's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Thomas Kolodge enrolled in Medicare?

No. Thomas Kolodge has opted out of Medicare through April 23, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Thomas Kolodge was last updated on August 12, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.