WASHINGTON DENTAL CORPORATION PC (NPI# 1811490550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811490550 |
| Entity Type | Organization |
| Organization Name | WASHINGTON DENTAL CORPORATION PC |
| Other Organization Name | LAKE STEVENS MODERN DENTISTRY |
| Practice Address |
907 Frontier Circle E Suite 110 Lake Stevens WA 98258 |
| Mailing Address |
17000 Red Hill Ave Irvine CA 92614-5626 |
| Practice Telephone | 4256979219 |
| Practice Fax Number | 4256979228 |
| Mailing Telephone | 7148458500 |
| Mailing Fax Number | 3039520892 |
| Enumeration Date | 2018-03-08 |
| Last Update Date | 2018-03-08 |
| Authorized Official Name | DULCE GOMEZ (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 7148458701 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Other Name | Type Code |
|---|---|
| Lake Stevens Modern Dentistry | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205249810 | Washington Dental Corporation PC | Dentist | 17420 Southcenter Pkwy, Tukwila, WA 98188-3701 | 2014-06-11 |
| 1114324795 | Washington Dental Corporation PC | Dentist | 16810 Meridian E Ste J107, Puyallup, WA 98375-9604 | 2014-11-26 |
| 1376945287 | Washington Dental Corporation PC | Dentist | 918 Se 164th Ave, Suite 200, Vancouver, WA 98683-9603 | 2014-09-23 |
| 1669874145 | Washington Dental Corporation PC | Dentist | 1001 Avenue D, Suite 100, Snohomish, WA 98290-2018 | 2014-09-16 |
| Street Address |
907 FRONTIER CIRCLE E SUITE 110 |
| City | LAKE STEVENS |
| State | WA |
| Zip Code | 98258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790349116 | Page A Thompson | Assistant Behavior Analyst | 9821 North Davies Rd, Lake Stevens, WA 98258 | 2019-05-01 |
| 1881140499 | Tracy L. Delorm, D.d.s. Pllc | Dentist | 9514 4th St. Ne Unit 102, Lake Stevens, WA 98258 | 2016-09-01 |
| 1932587870 | Nathan Cory | Contractor | 25 95th Dr Ne #105, Lake Stevens, WA 98258 | 2015-05-12 |
| 1902249063 | Troy Slover | Family Medicine | 31 Ne Route 300 Suite 200, Belfair, WA 98258 | 2013-04-09 |
| 1154675064 | Pspd - Lake Stevens Pllc | Dentist | 9421 N. Davies Road #a, Lake Stevens, WA 98258 | 2012-10-30 |
| 1053670364 | Ashley Nicole Sherman | Massage Therapist | 9623 32nd St Se Bldg D Ste 115, Lake Stevens, WA 98258 | 2012-05-07 |
| 1326344391 | Lyman Charles Drown | Specialist/Technologist | 9514 4th Street Ne, Suite 101, Lake Stevens, WA 98258 | 2011-02-08 |
| 1942504071 | Rebekah Erin Callahan | Marriage & Family Therapist | 7304 10th St. Se #b201, Lake Stevens, WA 98258 | 2011-01-04 |
| 1376857235 | Ronald L Rhea | Massage Therapist | 7812 12th St Se, Lake Stevens, WA 98258 | 2010-08-03 |
| 1679725964 | Marsha Marie Graf | Massage Therapist | 12506 18th Street N.e., Lake Stevens, WA 98258 | 2008-10-17 |
| Find all providers in zip 98258 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | 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 requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881140499 | Tracy L. Delorm, D.d.s. Pllc | Dentist | 9514 4th St. Ne Unit 102, Lake Stevens, WA 98258 | 2016-09-01 |
| 1275942518 | South Lake Family Dentistry | Dentist | 10515 20th St Se, Suite 201, Lake Stevens, WA 98258-4764 | 2014-08-12 |
| 1902002363 | Johnny Tseng-yung Tien | Dentist | 921 Vernon Rd, Lake Stevens, WA 98258-7931 | 2007-06-22 |
| 1942342498 | Loree D Olson Bolin | Dentist | 515 Highway 9, Suite #102, Lake Stevens, WA 98258 | 2007-02-13 |
| 1871635755 | Scott W.w. Steedman | Dentist | 515 State Route 9 Ne Ste 101, Lake Stevens, WA 98258-8523 | 2007-02-13 |
| 1487674966 | Fred C Chittenden | Dentist | 2012 Grade Rd Ste 201, Lake Stevens, WA 98258-9135 | 2006-07-20 |
| 1710965678 | Robert Michael Shandera | Dentist | 9421 N Davies Rd, Lake Stevens, WA 98258-9444 | 2006-01-02 |
| 1548810104 | Hyunsoo Lim | Dentist | 8933 Market Pl, Lake Stevens, WA 98258-4909 | 2019-09-16 |
| 1639665383 | Ryan Price | Dentist | 22 95th Dr Ne, Lake Stevens, WA 98258 | 2018-07-05 |
| 1063787497 | Dustin Michael Davis | Dentist | 22 95th Dr Ne, Lake Stevens, WA 98258-7975 | 2012-03-19 |
| Find all providers in LAKE STEVENS | ||||
| City | LAKE STEVENS |
| Zip Code | 98258 |
Please comment or provide details below to improve the information on WASHINGTON DENTAL CORPORATION PC.
| 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.