NPIMap

Organization Active NPI

Solo Denture and Dental Clinic Inc

  • Dental Clinic/Center
  • Lynnwood, WA
National Provider Identifier
1013381045
Registry record updated Nov 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DN60612122 Issued in WA
Legal business name
SOLO DENTURE AND DENTAL CLINIC INC
Practice address
7411 196TH St SW
Lynnwood, WA 98036-5052
Phone
(425) 678-1166
Fax
(425) 678-1167
NPI assigned
Nov 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2015

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

Authorized official

Name
Dr. Oleksandr Stasyuk, D.P.DNPI 1306211479
Title
Owner
Phone
(425) 346-1604

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 DN60612122 WA Primary

Addresses

Primary practice location

7411 196TH St SW
Lynnwood, WA 98036-5052

Mailing address

7924 236TH St SW Apt 300
Edmonds, WA 98026-8838
Phone (425) 346-1604

National Provider Directory

National Provider Directory

Locations

7411 196th St SW
Lynnwood, WA 98036
Phone (425) 678-1166

Practitioners & affiliated clinicians

Practitioners 2

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": "1447372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447372800000",
    "number": "1013381045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7924 236TH ST SW APT 300",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268838",
            "telephone_number": "425-346-1604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7411 196TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980365052",
            "telephone_number": "425-678-1166",
            "fax_number": "425-678-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLO DENTURE AND DENTAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-13",
        "last_updated": "2015-11-13",
        "status": "A",
        "authorized_official_last_name": "STASYUK",
        "authorized_official_first_name": "OLEKSANDR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-346-1604",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.D"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "DN60612122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2015; 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.