NPIMap

Organization Active NPI

JS Dental Clinic, LLC

  • Dental Clinic/Center
  • Kent, WA
National Provider Identifier
1023376225
Registry record updated Apr 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
603197556 Issued in WA
Legal business name
JS DENTAL CLINIC, LLC
Practice address
9735 S 222ND St
Kent, WA 98031-2410
Phone
(206) 661-0520
NPI assigned
Apr 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2012

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

Authorized official

Name
Lolita Guevarra Santos, DENTURISTNPI 1053679258
Title
Denturist
Phone
(206) 661-0520

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 603197556 WA Primary

Addresses

Primary practice location

9735 S 222ND St
Kent, WA 98031-2410

Mailing address

9735 S 222ND St
Kent, WA 98031-2410
Phone (206) 661-0520

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": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1023376225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9735 S 222ND ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980312410",
            "telephone_number": "206-661-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9735 S 222ND ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980312410",
            "telephone_number": "206-661-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JS DENTAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "SANTOS",
        "authorized_official_first_name": "LOLITA",
        "authorized_official_middle_name": "GUEVARRA",
        "authorized_official_title_or_position": "DENTURIST",
        "authorized_official_telephone_number": "206-661-0520",
        "authorized_official_credential": "DENTURIST"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "603197556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.