Organization · Type 2 NPI

South Coast Dental Group LLC

Dentist · Coos Bay, OR

NPI number 1790096402 Active

Practice location

295 S 10th St
Coos Bay, OR 97420-4623

Call (541) 269-5353 Map

Fax (541) 266-0933

Other practice locations

155 Delaware Ave SE, Bandon, OR 97411-9471 · (541) 551-7347

Specialties and licenses

Taxonomy	Code	License
Dentist Primary	122300000X	D9399 (OR)

Dentist: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requiremen…

7 other providers at this address

NPI record

NPI: 1790096402
Entity type: Organization (Type 2)
Issued: Jun 28, 2010
Last updated: May 14, 2026
Status: Active

Other names

<unavail>
South Coast Family Dentistry · doing business as
South Coast Family Dentistry · doing business as
South Coast Dental Group · other name

Authorized official

Mr. Nicholas I Horn
Billing & Claims Manager
(541) 269-5353

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1790096402

South Coast Dental Group LLC's National Provider Identifier is 1790096402, issued on Jun 28, 2010. The primary taxonomy on file is Dentist (122300000X), and the practice location is in Coos Bay, OR. The record was last updated on May 14, 2026.