WILDWOOD DENTAL GROUP (NPI# 1659580249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659580249 |
| Entity Type | Organization |
| Organization Name | WILDWOOD DENTAL GROUP |
| Other Organization Name | BECK HAYRE SKIBIEL AND BERRY PLLC |
| Practice Address |
1617 183rd St Se Ste 1 Mill Creek WA 98012-6812 |
| Practice Telephone | 4253680600 |
| Practice Fax Number | 4257883285 |
| Mailing Telephone | 4253680600 |
| Mailing Fax Number | 4257883285 |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2010-12-16 |
| Authorized Official Name | DR. GEORGE DOUGLAS BECK (MANAGER) |
| Authorized Official Telephone | 4253680611 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DE 04901 | WA | Dental Providers |
| Other Name | Type Code |
|---|---|
| Beck Hayre Skibiel and Berry PLLC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659798262 | Wildwood Dental Group | Dentist | 3972 N Waterman Ave, San Bernardino, CA 92404-1700 | 2014-03-20 |
| Street Address |
1617 183RD ST SE STE 1 |
| City | MILL CREEK |
| State | WA |
| Zip Code | 98012-6812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750685327 | G Douglas Beck Dds Ps | Dentist | 1617 183rd St Se Ste 1, Mill Creek, WA 98012-6812 | 2010-12-22 |
| 1164631651 | G Douglas Beck | Dentist | 1617 183rd St Se Ste 1, Mill Creek, WA 98012-6812 | 2007-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811502032 | Malia Van-frances Chase | Behavioral Analyst | 18311 Bothel-everett Hwy, Suite 260, Bothell, Wa, WA 98012 | 2020-09-14 |
| 1154951804 | Thea E Byrne | Physical Therapist | 6030 Bothell Everett Hwy, #140, Mill Creek, WA 98012 | 2020-01-22 |
| 1861975526 | Jenifer Rae Denormandie | Pharmacist | 14529 North Creek Drive Apt B210, Mill Creek, WA 98012 | 2018-09-10 |
| 1780161760 | Azadeh Fariba | Naturopath | 15411 40th Dr Se, Bothell, WA 98012 | 2018-07-23 |
| 1720572902 | Rickey Lee Mcgregor | Counselor | 16300 Mill Creek Blvd, Suite 204, Mill Creek, WA 98012 | 2018-06-20 |
| 1306349865 | Rudi Lauren Romaine | Behavioral Analyst | 18311 Bothell-everett Hwy, Suite 260, Bothell, WA 98012 | 2018-03-12 |
| 1164961025 | Wickler Behavioral Consulting | Behavioral Analyst | 632 182nd Street Se, Bothell, WA 98012 | 2017-02-13 |
| 1588026413 | Nathan Earl Crawford | Massage Therapist | 18930 Bothell Everett Hwy, D302, Bothell, WA 98012 | 2016-03-21 |
| 1144618083 | Jocelyn Enabulele | Counselor | 19105 Waxen Road, Bothell, WA 98012 | 2014-12-30 |
| 1124426846 | Teeth R Us | Dentist | 1908 201 Pl Se Suite #201, Bothell, WA 98012 | 2014-12-11 |
| Find all providers in zip 98012 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639553795 | Kyuan Kim | Dentist | 15224 Main St Ste 300, Mill Creek, WA 98012-7332 | 2015-07-17 |
| 1255768834 | Doug Beck Pllc | Dentist | 1617 183rd St Se Ste 6, Mill Creek, WA 98012-6812 | 2013-09-27 |
| 1629372925 | Gdbeck Pllc | Dentist | 1617 183rd St Se Ste 5, Mill Creek, WA 98012-6812 | 2010-12-29 |
| 1366696114 | Cosmetic & Family Dentistry of Mill Creek | Dentist | 16504 9th Ave Se Ste 103, Mill Creek, WA 98012-6388 | 2008-11-06 |
| 1780847129 | Todd J Berggren | Dentist | 15421 Main St, Ste 101, Mill Creek, WA 98012-9002 | 2008-07-07 |
| 1306041496 | Adam W Berry | Dentist | 1617 183rd St Se, Mill Creek, WA 98012-6812 | 2007-06-18 |
| 1679796056 | Cason Frederick Culberson | Dentist | 16030 Bothell Everett Hwy Ste 280, Mill Creek, WA 98012-1599 | 2007-04-11 |
| 1720104698 | Roger Allen Flake | Dentist | 13416 Bothell Everett Hwy, Suite 207, Mill Creek, WA 98012-5311 | 2007-03-22 |
| 1447382353 | Thomas C Mccullough | Dentist | 3226 132nd St Sw, Ste 106, Mill Creek, WA 98012 | 2007-03-09 |
| 1437284148 | Family Dental Care of Mill Creek | Dentist | 16030 Bothell Everett Hwy Ste 260, Mill Creek, WA 98012-1274 | 2007-02-22 |
| Find all providers in MILL CREEK | ||||
| City | MILL CREEK |
| Zip Code | 98012 |
Please comment or provide details below to improve the information on WILDWOOD DENTAL GROUP.
| 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.