LILLY DENTURE CENTER, INC (NPI# 1851459069) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851459069 |
| Entity Type | Organization |
| Organization Name | LILLY DENTURE CENTER, INC |
| Practice Address |
200 Lilly Rd Ne Ste A Olympia WA 98506-5080 |
| Practice Telephone | 3604120812 |
| Practice Fax Number | 3604120814 |
| Mailing Telephone | 3604120812 |
| Mailing Fax Number | 3604120814 |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. PATRICK M CARBONE (DENTURIST) |
| Authorized Official Telephone | 3604120812 |
| Authorized Official Credential | D.P.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122400000X | Denturist | DN00000194 | WA | Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | LILLY DENTURE CENTER, INC. | 200 Lilly Rd Ne Ste A, Olympia, WA 98506-5080 |
| Street Address |
200 LILLY RD NE STE A |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98506-5080 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740602176 | Patrick Carbone | Denturist | 200 Lilly Rd Ne Ste A, Olympia, WA 98506-5080 | 2014-01-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477185460 | Chloe Harper | Technician, Other | 3443 Lilly Rd Se, Ste B, Olympia, WA 98506 | 2020-02-07 |
| 1912543539 | Jessica Marie Radakovich | Licensed Practical Nurse | 3426 Mary Elder Rd, Olympia, WA 98506 | 2019-11-19 |
| 1669014973 | Arlene Josephine Adams | Registered Nurse | 413 Lily Rd Ne, Olympia, WA 98506 | 2019-10-09 |
| 1861999120 | Debra Delores Barker | Licensed Practical Nurse | 3710 South Bay Rd Ne, Olympia, WA 98506 | 2018-04-12 |
| 1801304431 | Michelle Warner | Nurse Practitioner | 205 Lilly Rd Ne Ste A1, Olympia, WA 98506 | 2018-01-17 |
| 1396258364 | Institute for Family Development | Community/Behavioral Health | 204 Quince St. Ne, Suite 200, Olympia, WA 98506 | 2017-11-13 |
| 1083137715 | Cameron Kunkel | Specialist/Technologist | 2512 20th Ave Ne, Olympia, WA 98506 | 2017-07-25 |
| 1184144768 | Trevor Shane Kwan | Family Medicine | 525 Lilly Road Ne, Olympia, WA 98506 | 2017-06-23 |
| 1073043212 | Michael H Harburg | Behavior Technician | 3857 Martin Way Ne, Olympia, WA 98506 | 2017-06-19 |
| 1780114371 | Priscilla Kangyang Jadu | Counselor | 3857 Martin Way E., Olympia, WA 98506 | 2017-06-15 |
| Find all providers in zip 98506 | ||||
| Taxonomy Code | 122400000X |
| Grouping | Dental Providers |
| Classification | Denturist |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740700145 | Joseph Brandon Kimmel | Denturist | 5032 Beverly Dr Ne, Olympia, WA 98516 | 2017-06-27 |
| 1093907222 | James M Elvin | Denturist | 1401 4th Ave E, Olympia, WA 98506-4484 | 2007-08-12 |
| 1700960978 | Julie Grace Stone | Denturist | 1700 Cooper Point Rd Sw Ste B3, Olympia, WA 98502-1110 | 2006-10-24 |
| 1740602176 | Patrick Carbone | Denturist | 200 Lilly Rd Ne Ste A, Olympia, WA 98506-5080 | 2014-01-21 |
| 1245359926 | Discovery Denture Center, Inc. | Denturist | 1700 Cooper Point Rd Sw Ste B3, Olympia, WA 98502-1110 | 2007-03-27 |
| 1891835310 | Fred E Ellis | Denturist | 1822 Black Lake Blvd Sw, Suite 101, Olympia, WA 98512 | 2007-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427689421 | Tri-cities Denture Studio Pllc | Denturist | 3909 Creekside Loop Ste 110, Yakima, WA 98902-4880 | 2020-01-29 |
| 1447894811 | Michael Hu | Denturist | 430 N West Ave Ste 3, Arlington, WA 98223-1539 | 2019-10-29 |
| 1265999494 | Sagebrush Dental LLC | Denturist | 1114 N Mission St Ste C, Wenatchee, WA 98801-6711 | 2019-02-24 |
| 1295299113 | Stephanie Jean Hemenway | Denturist | 209 W Main Ave., Morton, WA 98356 | 2019-01-24 |
| 1538633664 | Trang Phung | Denturist | 1242 State Ave Ste G, Marysville, WA 98270-3672 | 2019-01-11 |
| 1053884338 | Juan Edward Berlanga | Denturist | 654 N Rochester St, Tacoma, WA 98406-1724 | 2019-01-09 |
| 1346713765 | Cody M Dunivin | Denturist | 129 Valley Meadows Dr, Chehalis, WA 98532-8652 | 2019-01-08 |
| 1841765682 | Andrew Payne | Denturist | 714 N Chelan Ave, Wenatchee, WA 98801-2069 | 2018-10-08 |
| 1154811982 | Jayson Allen Laney | Denturist | 4001 Colby Ave Ste 2, Everett, WA 98201-6208 | 2018-05-17 |
| 1932697117 | Jason Lee Alsbury | Denturist | 1715 W Kennewick Ave, Kennewick, WA 99336-3378 | 2018-04-24 |
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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.