SOUTH HILL CHILDRENS DENTISTRY (NPI# 1821159047) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821159047 |
| Entity Type | Organization |
| Organization Name | SOUTH HILL CHILDRENS DENTISTRY |
| Practice Address |
11102 Sunrise Blvd E Suite 108 Puyallup WA 98374-8846 |
| Mailing Address |
11102 Sunrise Blvd Suite 108 Puyallup WA 98374-8846 |
| Practice Telephone | 2538481022 |
| Practice Fax Number | 2538480218 |
| Mailing Telephone | 2538481022 |
| Mailing Fax Number | 2538480218 |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JAMES L MILLER (OWNER) |
| Authorized Official Telephone | 2538481022 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
6837 | WA | Dental Providers |
| Street Address |
11102 SUNRISE BLVD E SUITE 108 |
| City | PUYALLUP |
| State | WA |
| Zip Code | 98374-8846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285612879 | Ted Coleman | Emergency Medicine | 11102 Sunrise Blvd E, Suite 103, Puyallup, WA 98374 | 2006-01-04 |
| 1669906376 | James Luzzo | Nurse Practitioner | 11102 Sunrise Blvd E, Suite 103, Puyallup, WA 98374-8846 | 2017-04-19 |
| 1558716043 | Emily Winn | Nurse Practitioner | 11102 Sunrise Blvd E, Suite 103, Puyallup, WA 98374-8846 | 2016-05-03 |
| 1033587944 | Rn Sunrise Operations LLC | Dietitian, Registered | 11102 Sunrise Blvd E, Suite 102, Puyallup, WA 98374-8846 | 2015-09-09 |
| 1801293949 | Devyn Catherine Cameron | Nurse Practitioner | 11102 Sunrise Blvd E, Suite 103, Puyallup, WA 98374-8846 | 2014-12-03 |
| 1003218611 | Scott Nelson | Physician Assistant | 11102 Sunrise Blvd E, Ste 103, Puyallup, WA 98374-8846 | 2014-09-25 |
| 1548685902 | Robert Rex Williams | Physician Assistant | 11102 Sunrise Blvd E, Ste 103, Puyallup, WA 98374-8846 | 2014-02-21 |
| 1477982700 | Melissa Bronoske | Physician Assistant | 11102 Sunrise Blvd E, Ste 103, Puyallup, WA 98374-8846 | 2013-11-07 |
| 1417395385 | Shannon Lee Moore | Nurse Practitioner | 11102 Sunrise Blvd E, Ste #110, Puyallup, WA 98374-8846 | 2013-06-12 |
| 1902113038 | Teresa Irene Garrison | Nurse Practitioner | 11102 Sunrise Blvd E, Suite 103, Puyallup, WA 98374-8846 | 2010-09-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073173977 | Courtney Yant | Registered Nurse | 300 3rd St Se, Puyallup, WA 98374 | 2019-06-13 |
| 1013480508 | Tracy Pina | Massage Therapist | 16909 123rd Ave E, Puyallup, WA 98374 | 2019-01-07 |
| 1922524917 | Edith M Wood | Registered Nurse | 13517 152nd St Ct E, Puyallup, WA 98374 | 2017-08-21 |
| 1669875993 | Jillian C S Longway | Registered Nurse | 11102 Sunrise Blvd E Ste 103, Puyallup, WA 98374 | 2014-10-01 |
| 1427302025 | Nadeem Jaffer | Internal Medicine | 3800 3rd St. Se, Puyallup, WA 98374 | 2012-11-04 |
| 1851605356 | Madigan Army Medical Ctr | Clinic/Center | 15600 Meridan Ave, Sunrise Village Center, East Puyallup, WA 98374 | 2010-07-27 |
| 1326368135 | Matt Karl Jahns | Massage Therapist | 2402 20th St Se, Puyallup, WA 98374 | 2010-06-03 |
| 1982833208 | Roxy Sturgeon | Speech-Language Pathologist | 2309 43rd Ave Se, Puyallup, WA 98374 | 2009-07-08 |
| 1497921191 | Morgan Counseling Services Inc. | Substance Abuse Rehabilitation Facility | 10312 120th Street East, Suite #3, Puyallup, WA 98374 | 2008-05-02 |
| 1700055795 | Walter Royal Patterson Jr. | Registered Nurse | 11102 Sunrise Blvd. E., Ste. 103, Woodcreek Healthcare, Puyallup, WA 98374 | 2008-02-25 |
| Find all providers in zip 98374 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619396652 | Clara W Brannan Dds, Ps | Dentist | 11102 Sunrise Blvd E Ste 108, Puyallup, WA 98374-8846 | 2014-04-07 |
| 1760482392 | Stuart G Hersey | Dentist | 11201 88th Ave E Suite 120, Puyallup, WA 98373 | 2005-07-26 |
| 1437686920 | Bora Kim | Dentist | 16810 Meridian E, Puyallup, WA 98375-9604 | 2017-05-16 |
| 1568997351 | Katherine Romelfanger | Dentist | 9317 113th St E, Suite A, Puyallup, WA 98373-3876 | 2017-04-29 |
| 1891158861 | Kids Choice Dental Puyallup, LLC | Dentist | 9317 113th St E, Suite A, Puyallup, WA 98373-3876 | 2016-03-29 |
| 1114324795 | Washington Dental Corporation PC | Dentist | 16810 Meridian E Ste J107, Puyallup, WA 98375-9604 | 2014-11-26 |
| 1528378700 | Jungwon Kim | Dentist | 16810 Meridian E, Puyallup, WA 98375-9604 | 2010-10-20 |
| 1174791529 | Ellen Polsky | Dentist | 9317 113th St E, Suite A, Puyallup, WA 98373 | 2008-02-19 |
| 1043346851 | Kevin H Sakai | Dentist | 311 River Rd, Suite 201, Puyallup, WA 98371-4113 | 2007-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740807890 | Plateau Kids Dentistry, LLC | Dentist | 2912 228th Ave Se Ste A, Sammamish, WA 98075-9305 | 2020-07-05 |
| 1528603503 | Ellen Polsky Dds and Bobby Virk Dmd, Ps | Dentist | 34704 11th Pl S Ste 101, Federal Way, WA 98003-8730 | 2019-11-13 |
| 1942843552 | Laura Stewart Dds Pllc | Dentist | 6821 Ne 181st St, Kenmore, WA 98028-5034 | 2019-10-26 |
| 1639736119 | Southcenter Children's Dentistry | Dentist | 411 Strander Blvd Ste 303, Tukwila, WA 98188-2924 | 2019-05-21 |
| 1770147001 | Kaitlin Neste Pllc | Dentist | 360 Tormey Ln Ne Ste 198, Bainbridge Island, WA 98110-1990 | 2019-04-22 |
| 1124511126 | Roger Lucas, P.s. | Dentist | 3806 116th St. Ne, Marysville, WA 98271 | 2018-06-13 |
| 1497248017 | Jinju Song Dmd Pllc | Dentist | 9707 Ne 119th Way, Kirkland, WA 98034-8955 | 2018-06-08 |
| 1861999864 | Peter Douglas | Dentist | 32105 1st Ave S Ste B3, Federal Way, WA 98003-5719 | 2018-04-07 |
| 1669994042 | Annikka Louise Frostad-thomas | Dentist | 700 Nw Gilman Blvd # E412, Issaquah, WA 98027-5395 | 2017-07-07 |
| 1831624402 | Minh Dau, Dds and Raymond Park, Dds Pllc | Dentist | 3105 Alderwood Mall Blvd, Suite 117, Lynnwood, WA 98036-4703 | 2017-04-20 |
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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.