NPIMap

Organization Active NPI

Olympic Dental & Denture Center, LLC

  • Dental Clinic/Center
  • Tacoma, WA
National Provider Identifier
1003148719
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
416 Issued in WA
Legal business name
OLYMPIC DENTAL & DENTURE CENTER, LLC
Practice address
3720 6TH Ave
Suite a
Tacoma, WA 98406-4938
Phone
(253) 752-1320
Fax
(253) 752-1425
NPI assigned
Feb 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Richard C Johnson, L.D,NPI 1679782973
Title
Ceo
Phone
(253) 752-1320

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 416 WA Primary

Addresses

Primary practice location

3720 6TH Ave
Suite a
Tacoma, WA 98406-4938

Mailing address

3720 6TH Ave
Suite a
Tacoma, WA 98406-4938
Phone (253) 752-1320

National Provider Directory

National Provider Directory
Tax ID family
Olympic Dental Denture Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265241600000",
    "number": "1003148719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 6TH AVE",
            "address_2": "SUITE A",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984064938",
            "telephone_number": "253-752-1320",
            "fax_number": "253-752-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 6TH AVE",
            "address_2": "SUITE A",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984064938",
            "telephone_number": "253-752-1320",
            "fax_number": "253-752-1425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLYMPIC DENTAL & DENTURE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-04",
        "last_updated": "2010-02-04",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "253-752-1320",
        "authorized_official_credential": "L.D,"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.