NPIMap

Organization Active NPI

Lavince Group PS

  • Dental Clinic/Center
  • Yelm, WA
National Provider Identifier
1043591043
Registry record updated Sep 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DE00006408 Issued in WA
Legal business name
LAVINCE GROUP PS
Doing business as
Yelm Prairie Dental
Practice address
202 First Street South,
Yelm, WA 98597
Phone
(360) 458-7645
Fax
(360) 458-2745
NPI assigned
Sep 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2011

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

Authorized official

Name
James Vincent Shuck
Title
VP
Phone
(360) 458-7645

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DE00006408 WA Primary

Addresses

Primary practice location

202 First Street South,
Yelm, WA 98597

Mailing address

PO Box 1568
Yelm, WA 98597-1568
Phone (360) 458-7645

Other names 1

  • Yelm Prairie Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
La Vince Group PS Dba2 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.

NPI Registry JSON

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

{
    "created_epoch": "1314921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316908800000",
    "number": "1043591043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1568",
            "city": "YELM",
            "state": "WA",
            "postal_code": "985971568",
            "telephone_number": "360-458-7645",
            "fax_number": "360-458-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 FIRST STREET SOUTH,",
            "city": "YELM",
            "state": "WA",
            "postal_code": "98597",
            "telephone_number": "360-458-7645",
            "fax_number": "360-458-2745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVINCE GROUP PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-02",
        "last_updated": "2011-09-25",
        "status": "A",
        "authorized_official_last_name": "SHUCK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "360-458-7645"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "DE00006408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yelm Prairie Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yelm, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2011; 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.