West Kent Dental LLC

Primary specialty

DentistTaxonomy code 122300000X

License

DE60487989 Issued in WA

Legal business name

WEST KENT DENTAL LLC

Practice address

23241 Pacific Hwy S
Kent, WA 98032-2721

Phone

(253) 878-8174

NPI assigned

Oct 30, 2014

Organization subpart

No

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

Authorized official

Name

Wyatt Wilson, DMD

Title

Dentist

Phone

(253) 878-8174

Specialties & licenses 1

Addresses

Other names 1

• Comfort Dental West Kent Doing business as

Locations

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414627200000",
    "number": "1083019210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23241 PACIFIC HWY S",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980322721",
            "telephone_number": "253-878-8174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23241 PACIFIC HWY S",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980322721",
            "telephone_number": "253-878-8174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST KENT DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-30",
        "last_updated": "2014-10-30",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "WYATT",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "253-878-8174",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60487989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comfort Dental West Kent",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Kent, WA
• Providers in Kent, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; 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.