# BLOOM PEDIATRIC DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841805991
- **Authorized official:** DR. BENJAMIN JAMES DDS (OWNER / DENTIST)
- **Authorized official phone:** (541) 666-6091

## Contact information

- **Practice address:** 410 E ELLENDALE AVE STE 1, DALLAS, OR 97338-3052
- **Practice address phone:** (503) 507-0996
- **Mailing address:** 410 E ELLENDALE AVE STE 1, DALLAS, OR 97338-3052
- **Mailing address phone:** (503) 507-0996

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 09/14/2020
- **Last updated:** 07/17/2026