NPIMap

Organization Active NPI

Nutter & Wilson PLLC

  • General Practice Dentistry
  • Vancouver, WA
National Provider Identifier
1023323144
Registry record updated Nov 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
00004959 Issued in WA
Legal business name
NUTTER & WILSON PLLC
Doing business as
Distinctive Dental Care
Practice address
601 SE 117TH Ave
Suite 230
Vancouver, WA 98683-5297
Phone
(360) 892-1170
Fax
(360) 604-1172
NPI assigned
Aug 12, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2010

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

Authorized official

Name
Dr. Daniel E Wilson, DMD
Title
Member of PLLC
Phone
(360) 892-1170

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 00009284 WA
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 00004959 WA Primary

Addresses

Primary practice location

601 SE 117TH Ave
Suite 230
Vancouver, WA 98683-5297

Mailing address

601 SE 117TH Ave
Suite 230
Vancouver, WA 98683-5297
Phone (360) 892-1170

Other names 1

  • Distinctive Dental Care Doing business as

National Provider Directory

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": "1281571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289779200000",
    "number": "1023323144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 SE 117TH AVE",
            "address_2": "SUITE 230",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835297",
            "telephone_number": "360-892-1170",
            "fax_number": "360-604-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 SE 117TH AVE",
            "address_2": "SUITE 230",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835297",
            "telephone_number": "360-892-1170",
            "fax_number": "360-604-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTTER & WILSON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-12",
        "last_updated": "2010-11-15",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEMBER OF PLLC",
        "authorized_official_telephone_number": "360-892-1170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "00009284",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "00004959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Distinctive Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.