Organization Active NPI

West Vancouver Dental LLC

  • General Practice Dentistry
  • Vancouver, WA
National Provider Identifier
1083562730
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
WEST VANCOUVER DENTAL LLC
Practice address
117 E 39TH St
Vancouver, WA 98663-2229
Phone
(360) 694-7931
Fax
(360) 694-0722
NPI assigned
Mar 18, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Authorized official

Name
Jared HawthorneNPI 1043862279
Title
Dentist/Owner
Phone
(360) 694-7931

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: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

117 E 39TH St
Vancouver, WA 98663-2229

Mailing address

117 E 39TH St
Vancouver, WA 98663-2229
Phone (360) 694-7931

National Provider Directory

National Provider Directory

Locations

117 E 39th St
Vancouver, WA 98663
Phone (360) 694-7931

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": "1773792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773792000000",
    "number": "1083562730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 E 39TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632229",
            "telephone_number": "360-694-7931",
            "fax_number": "360-694-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E 39TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632229",
            "telephone_number": "360-694-7931",
            "fax_number": "360-694-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST VANCOUVER DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-18",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A",
        "authorized_official_last_name": "HAWTHORNE",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "360-694-7931"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 18, 2026; 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.