SUMMIT DENTAL LAB (NPI# 1518406339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518406339 |
| Entity Type | Organization |
| Organization Name | SUMMIT DENTAL LAB |
| Practice Address |
1590 Woodridge Dr Se Port Orchard WA 98366-3818 |
| Mailing Address |
4782 Rutherford Cir Sw Port Orchard WA 98367-6430 |
| Practice Telephone | 3608712444 |
| Mailing Telephone | 3608760238 |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-02-13 |
| Authorized Official Name | ALLEN BURLESON (OWNER-DENTAL LAB) |
| Authorized Official Telephone | 3608712444 |
| Authorized Official Credential | CDT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 292200000X | Dental Laboratory | 603128257 | WA | Laboratories |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | SUMMIT DENTAL LABORATORY, INC. | Robert Hyunsuk Kim, 47-01 Queens Blvd Ste 206, Sunnyside, New York 11104 |
| Street Address |
1590 WOODRIDGE DR SE |
| City | PORT ORCHARD |
| State | WA |
| Zip Code | 98366-3818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437171246 | Justin Lee Robison | Dentist | 1590 Woodridge Dr Se, Port Orchard, WA 98366-3818 | 2006-07-24 |
| 1154737823 | Steven C. Chobot, Dds, Ps | Dentist | 1590 Woodridge Dr Se, Port Orchard, WA 98366-3818 | 2014-07-02 |
| 1770999534 | Melany K. Bloomquist, Dds, Ps | Dentist | 1590 Woodridge Dr Se, Port Orchard, WA 98366-3818 | 2014-07-01 |
| 1174754964 | Justin L. Robison Dmd P.C. | Dentist | 1590 Woodridge Dr Se, Port Orchard, WA 98366-3818 | 2009-07-28 |
| 1902026834 | Melany K Bloomquist | Dentist | 1590 Woodridge Dr Se, Port Orchard, WA 98366-3818 | 2007-04-25 |
| 1841419777 | Steven C Chobot | Dentist | 1590 Woodridge Dr Se, Port Orchard, WA 98366-3818 | 2007-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003423302 | Teresa M Derouin | Speech-Language Pathologist | Harbor Speech Pathology, 463 Tremont St W Suite 110, Port Orchard, WA 98366 | 2020-09-30 |
| 1316591217 | Martin Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 8079 E Main Street, Suite 101, Port Orchard, WA 98366 | 2019-07-29 |
| 1952822660 | Kristian Thomas Workman Haskins | Hearing Instrument Specialist | 1328 Colchester Drive S.e., Port Orchard, WA 98366 | 2017-07-03 |
| 1013466929 | Jenna Olafson | Counselor | 414 Front St. N, Issaquah, WA 98366 | 2016-10-04 |
| 1063884534 | Laurine Burrer | Licensed Practical Nurse | 2874 Se Lund Ave, Port Orchard, WA 98366 | 2015-10-23 |
| 1346640836 | Karen Diane Thompson | Pharmacy Technician | 1800 Sidney Ave, Apt 1-201, Port Orchard, WA 98366 | 2014-09-03 |
| 1588912042 | Celeste Kyle Interrante | Physical Therapy Assistant | 2051 Pottery Ave., Port Orchard, WA 98366 | 2012-08-15 |
| 1013227339 | Christine Davis | Massage Therapist | 1800 Se Mile Hill Drive, Suite 150, Port Orchard, WA 98366 | 2010-10-20 |
| 1932421724 | Mary Jo Stump | Physical Therapy Assistant | 2051 Pottery Avenue, Port Orchard, WA 98366 | 2010-02-19 |
| 1669707626 | Shannon Mary Baurichter | Speech-Language Pathologist | 1230 Bay St, Port Orchard, WA 98366 | 2009-10-08 |
| Find all providers in zip 98366 | ||||
| Taxonomy Code | 292200000X |
| Grouping | Laboratories |
| Classification | Dental Laboratory |
| A commercial laboratory specializing in the construction of dental appliances that conform to a dentist’s specifications including the construction of dentures (complete or partial), orthodontic appliances, bridgework, crowns, and inlays. |
| Notes: Source: Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 1245. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316266760 | Re Anderson Dental Lab | Dental Laboratory | 1915 N Division St, Spokane, WA 99207-2253 | 2010-05-25 |
| 1447429840 | R-k Holdings Inc | Dental Laboratory | 705 Se Park Crest Ave, Suite A 130, Vancouver, WA 98683-1304 | 2008-02-29 |
| 1558803171 | J.a. Denture Clinic LLC | Dental Laboratory | 3226 208th Pl Sw, Lynnwood, WA 98036-7884 | 2016-11-14 |
| 1780139931 | The Professional Denture Center | Dental Laboratory | 533 S Mission St, Wenatchee, WA 98801-3047 | 2016-08-17 |
| 1750704540 | Tacoma Diagnostic Imaging Center, LLC | Dental Laboratory | 6004 Westgate Blvd, Suite 210, Tacoma, WA 98406-2503 | 2014-01-29 |
| 1144653601 | Arcus Laboratory | Dental Laboratory | 5701 Ne Bothell Way, Suite 7, Kenmore, WA 98028-9400 | 2013-08-19 |
| 1053697243 | Northpointe Imaging Center, LLC | Dental Laboratory | 9425 N Nevada St Ste 100, Spokane, WA 99218-1286 | 2011-11-01 |
| 1114229721 | Sheeler Denture Clinic | Dental Laboratory | 680 W Washington St, Suite E-106, Sequim, WA 98382-3264 | 2010-12-02 |
| 1497070650 | Dentures 4 U Lab Inc | Dental Laboratory | 5219 W Clearwater Ave, Suite 3, Kennewick, WA 99336-1914 | 2010-03-31 |
| City | PORT ORCHARD |
| Zip Code | 98366 |
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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.