NPIMap

Organization Active NPI

Villaluz and Rodriguez, PS

  • General Practice Dentistry
  • Vancouver, WA
National Provider Identifier
1053638585
Registry record updated Apr 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00008204 Issued in WA
Legal business name
VILLALUZ AND RODRIGUEZ, PS
Doing business as
South View Family Dental
Practice address
3200 SE 164TH Ave Ste 207
Vancouver, WA 98683-1109
Phone
(360) 567-0296
Fax
(360) 567-0299
NPI assigned
Apr 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2010

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

Authorized official

Name
Joseph P Villaluz, DDSNPI 1245301357
Title
Owner
Phone
(360) 567-0296

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DE00008204 WA Primary

Addresses

Primary practice location

3200 SE 164TH Ave Ste 207
Vancouver, WA 98683-1109

Mailing address

3200 SE 164TH Ave Ste 207
Vancouver, WA 98683-1109
Phone (360) 567-0296

Other identifiers 1

IdentifierTypeStateIssuer
5051651MedicaidWA

Other names 1

  • South View Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

3200 SE 164th Ave
Ste 207
Vancouver, WA 98683
Phone (360) 567-0296

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": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271980800000",
    "number": "1053638585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 SE 164TH AVE STE 207",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986831109",
            "telephone_number": "360-567-0296",
            "fax_number": "360-567-0299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SE 164TH AVE STE 207",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986831109",
            "telephone_number": "360-567-0296",
            "fax_number": "360-567-0299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLALUZ AND RODRIGUEZ, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A",
        "authorized_official_last_name": "VILLALUZ",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-567-0296",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00008204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5051651",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South View Family Dental",
            "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 Apr 23, 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.