TRI-STAR DENTURE CLINIC (NPI# 1407176993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407176993 |
| Entity Type | Organization |
| Organization Name | TRI-STAR DENTURE CLINIC |
| Practice Address |
2802 Columbia St Vancouver WA 98660-2220 |
| Practice Telephone | 3609060015 |
| Practice Fax Number | 3609060023 |
| Mailing Telephone | 3609060015 |
| Mailing Fax Number | 3609060023 |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2010-06-07 |
| Authorized Official Name | MR. LENARD GOBIN DEOCHAND (DENTURIST) |
| Authorized Official Telephone | 3609060015 |
| Authorized Official Credential | LD, DD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | WA00008442 | WA | Dental Providers |
| Y | 122400000X | Denturist | DN00000394 | WA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 278500 | 05 | |
| WA | 5047667 | 05 |
| Street Address |
2802 COLUMBIA ST |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98660-2220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386782282 | Lenard Gobin Deochand | Denturist | 2802 Columbia St, Vancouver, WA 98660-2220 | 2007-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538779137 | Peacehealth Networks On Demand, LLC | Non-Pharmacy Dispensing Site | 781 W Columbia Way, Vancouver, WA 98660 | 2020-08-07 |
| 1538641527 | Melissa Molly Sivaram | Counselor | 1012 Esther St, Vancouver, WA 98660 | 2018-09-05 |
| 1679082598 | Christopher Lewis Schwab | Peer Specialist | 5197 Nw Lower River Rd, Vancouver, WA 98660 | 2017-09-22 |
| 1023560141 | Disabled Veterans Hawaii LLC | Durable Medical Equipment & Medical Supplies | 4817 Nw Fruit Valley Road, Suite 100, Vancouver, WA 98660 | 2016-10-25 |
| 1023493004 | Laura Nicole Wood | Counselor | 1104 Main St Ste M100, Vancouver, WA 98660 | 2015-07-20 |
| 1790034627 | Clark County Juvenile Court | Marriage & Family Therapist | 500 W 11th Street, Vancouver, WA 98660 | 2012-09-06 |
| 1538439104 | Hutton Chiropractic Clinic Inc | Chiropractor | 703 Broadway Street, Ste 650, Vancouver, WA 98660 | 2012-01-12 |
| 1134422629 | Brenda Marie Bible | Social Worker | 101 E 8th St Ste 110, Vancouver, WA 98660 | 2010-12-06 |
| 1871895409 | Donna L Benedicktus | Contractor | 210 E Evergreen Blvd, Vancouver, WA 98660 | 2010-12-02 |
| 1992007801 | Peter Ray Hasemeier | Massage Therapist | 805 Broadway St., Vancouver, WA 98660 | 2010-11-29 |
| Find all providers in zip 98660 | ||||
| Taxonomy Code | 122400000X |
| Grouping | Dental Providers |
| Classification | Denturist |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710429170 | Maged Mohareb | Denturist | 10800 Se 17th Cir Apt 230, Vancouver, WA 98664-6222 | 2016-11-15 |
| 1841605235 | Ronald Johnson | Denturist | 4804 Ne Thurston Way Ste C, Vancouver, WA 98662-6478 | 2014-06-25 |
| 1942630645 | Vadim Zalyashko | Denturist | 13720 Ne 28th St Ste B, Vancouver, WA 98682-8289 | 2013-11-15 |
| 1659596955 | Logan V May | Denturist | 16111 Se Mcgillivray Blvd, Suite H, Vancouver, WA 98683-9033 | 2007-04-13 |
| 1386782282 | Lenard Gobin Deochand | Denturist | 2802 Columbia St, Vancouver, WA 98660-2220 | 2007-02-02 |
| 1700938248 | Jana Moga | Denturist | 2314 Fort Vancouver Way, Vancouver, WA 98663 | 2007-01-17 |
| 1659484244 | R-k Holdings Inc | Denturist | 4804c Ne Thurston Way, Vancouver, WA 98662 | 2006-08-16 |
| 1598704033 | Thomas Albert Bohna | Denturist | 14602 Ne 4th Plain Rd, Suite G, Vancouver, WA 98682-5000 | 2006-06-06 |
| 1821654450 | Vyacheslav P Zalyashko | Denturist | 13720 Ne 28th St Ste B, Vancouver, WA 98682-8289 | 2019-05-20 |
| 1184051054 | Evergreen Denture Center | Denturist | 13720 Ne 28th St, Vancouver, WA 98682-8289 | 2013-10-08 |
| Find all providers in VANCOUVER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.