OLYMPIC DENTAL CENTER LLC (NPI# 1841318912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841318912 |
| Entity Type | Organization |
| Organization Name | OLYMPIC DENTAL CENTER LLC |
| Practice Address |
716 W Main St Centralia WA 98531-2847 |
| Practice Telephone | 3607360795 |
| Practice Fax Number | 3603301637 |
| Mailing Telephone | 3607360795 |
| Mailing Fax Number | 3603301637 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JOHN M ANDERSON (OWNER) |
| Authorized Official Telephone | 3607360795 |
| Authorized Official Credential | LD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 5038377 | 05 | |
| WA | UNITED CONCORDIA PROVIDER | 1412978 | 01 |
| Street Address |
716 W MAIN ST |
| City | CENTRALIA |
| State | WA |
| Zip Code | 98531-2847 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992109235 | Elizabeth Helder | Dental Hygienist | 716 W Main St, Centralia, WA 98531-2847 | 2014-10-15 |
| 1720366149 | Scott David Crane | Dentist | 716 W Main St, Centralia, WA 98531-2847 | 2011-08-02 |
| 1417189739 | C David Stevens | Dentist | 716 W Main St, Centralia, WA 98531-2847 | 2009-08-20 |
| 1679718159 | Joseph Thurston | Dentist | 716 W Main St, Centralia, WA 98531-2847 | 2008-12-11 |
| 1215053988 | Eileen Kuo Deskins | Dentist | 716 W Main St, Centralia, WA 98531-2847 | 2007-03-22 |
| 1881789105 | Edith Wong | Dentist | 716 W Main St, Centralia, WA 98531-2847 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306462205 | Jelisa Renae Thomas | Counselor | 3510 Steelhammer Ln, Centralia, WA 98531 | 2020-06-17 |
| 1205498607 | Jennifer Kristine Mcglynn Paterno | Counselor | 2428 W. Reynods Ave, Centralia, WA 98531 | 2019-07-05 |
| 1538646328 | Adam Jeffrey Moore | Counselor | 3510 Steelhammer Lane, Centralia, WA 98531 | 2018-07-24 |
| 1144706698 | Euijeong Kim | Occupational Therapist | Rehabilitation Therapies, 914 S. Scheuber Rd, Centralia, WA 98531 | 2018-07-18 |
| 1104315266 | Margaret Fowler Floyd | Registered Nurse | Centralia High School, 813 Eshom Road, Centralia, WA 98531 | 2018-05-04 |
| 1124545777 | Samantha Michelle Moody | Speech-Language Pathologist | Centralia School District, 2320 Borst Ave, Centralia, WA 98531 | 2017-08-24 |
| 1821520289 | Alexa Franks | Behavior Technician | 2428 West Reynolds Ave., Centralia, WA 98531 | 2017-04-03 |
| 1023559861 | Brandy Michelle Peterson | Counselor | 135 W. Main Steet, Centralia, WA 98531 | 2017-03-13 |
| 1841738812 | Graceful Healing Naturopathic | Naturopath | 219 N Tower Ave, Suite 304, Centralia, WA 98531 | 2017-02-09 |
| 1043681513 | Angela Naillon | Counselor | 2428 West Reynolds, Centralia, WA 98531 | 2015-10-09 |
| Find all providers in zip 98531 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700671 | K.lee, Dds, Pllc. | Clinic/Center | 20709 Mountain Hwy E # 102, Spanaway, WA 98387-8580 | 2020-11-06 |
| 1346841376 | Ralf F. Schuler, Dr. Med. Dent., Msd,pllc | Clinic/Center | 205 W Fairhaven Ave Ste C, Burlington, WA 98233-1062 | 2020-11-05 |
| 1356942684 | Healthy Smiles Northwest | Clinic/Center | 11808 18th St Se, Lake Stevens, WA 98258-2046 | 2020-11-03 |
| 1306446240 | Christine A Woodward, Dds, Pllc | Clinic/Center | 45860 Main St, Concrete, WA 98237 | 2020-10-29 |
| 1215535695 | Ellingsen Henneberg Pllc | Clinic/Center | 2607 S Southeast Blvd Ste B210, Spokane, WA 99223-7614 | 2020-10-16 |
| 1174121792 | Evolve Dental LLC | Clinic/Center | 4410 194th St Sw Ste A, Lynnwood, WA 98036-5598 | 2020-10-15 |
| 1326646035 | Natasha Habib Dds Ps | Clinic/Center | 1025 153rd St Se Ste 103, Mill Creek, WA 98012-4051 | 2020-10-14 |
| 1386241636 | Mellissa Ilgen, Dds, Pllc | Clinic/Center | 26114 Illinois Ave Ne, Kingston, WA 98346-7674 | 2020-10-08 |
| 1417554932 | Young, Yeung, Lee, Hockin, P.s | Clinic/Center | 2207 2nd Ave, Seattle, WA 98121-2016 | 2020-10-07 |
| 1164039731 | Consolidated Dental Three | Clinic/Center | 19221 108th Ave Se Ste 2, Renton, WA 98055-7369 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on OLYMPIC DENTAL CENTER LLC.
| 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.