NPIMap

Organization Active NPI

Andrea M. Vancleave, DDS, PLLC

Doing business as Olympia Pediatric Dentistry

  • Pediatric Dentistry
  • Olympia, WA
National Provider Identifier
1053654525
Registry record updated Apr 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DE60284724 Issued in WA
Legal business name
ANDREA M. VANCLEAVE, DDS, PLLC
Doing business as
Olympia Pediatric Dentistry
Practice address
2612 Yelm Hwy SE
Suite a
Olympia, WA 98501-4826
Phone
(360) 352-3515
Fax
(360) 352-0158
NPI assigned
Apr 2, 2013
Last updated
Apr 2, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2013

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

Authorized official

Name
Dr. Andrea Marie Vancleave, D.D.S.
Title
Member
Phone
(360) 352-3515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DE60284724 WA Primary

Addresses

Primary practice location

2612 Yelm Hwy SE
Suite a
Olympia, WA 98501-4826

Mailing address

2612 Yelm Hwy SE
Suite a
Olympia, WA 98501-4826
Phone (360) 352-3515

Other names 1

  • Olympia Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

2612 Yelm Hwy SE
#A
Olympia, WA 98501
Phone (360) 352-3515

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1364860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364860800000",
    "number": "1053654525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2612 YELM HWY SE",
            "address_2": "SUITE A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985014826",
            "telephone_number": "360-352-3515",
            "fax_number": "360-352-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2612 YELM HWY SE",
            "address_2": "SUITE A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985014826",
            "telephone_number": "360-352-3515",
            "fax_number": "360-352-0158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREA M. VANCLEAVE, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-02",
        "last_updated": "2013-04-02",
        "status": "A",
        "authorized_official_last_name": "VANCLEAVE",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "360-352-3515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE60284724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olympia Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2013; 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.