NPIMap

Organization Active NPI

Justin Courtney DDS PS

  • Dentist
  • Renton, WA
National Provider Identifier
1033480108
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
00010735 Issued in WA
Legal business name
JUSTIN COURTNEY DDS PS
Practice address
280 Hardie Ave SW
Suite 3
Renton, WA 98057-5900
Phone
(425) 336-1643
NPI assigned
Jan 22, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Authorized official

Name
Justin Courtney, DDSNPI 1821143819
Title
President
Phone
(425) 430-0400

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 00010735 WA Primary

Addresses

Primary practice location

280 Hardie Ave SW
Suite 3
Renton, WA 98057-5900

Mailing address

280 Hardie Ave SW
Suite 3
Renton, WA 98057-5900
Phone (425) 336-1643

National Provider Directory

National Provider Directory

Locations

280 Hardie Ave SW
Ste 3
Renton, WA 98057
Phone (425) 340-0400

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": "1327190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646697600000",
    "number": "1033480108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 HARDIE AVE SW",
            "address_2": "SUITE 3",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980575900",
            "telephone_number": "425-336-1643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 HARDIE AVE SW",
            "address_2": "SUITE 3",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980575900",
            "telephone_number": "425-336-1643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN COURTNEY DDS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-22",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A",
        "authorized_official_last_name": "COURTNEY",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-430-0400",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "00010735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.