Salmon Creek Oral & Maxillofacial Surgery,LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

WA5774 Issued in WA

Legal business name

SALMON CREEK ORAL & MAXILLOFACIAL SURGERY,LLC

Practice address

14411 NE 20TH Ave
Suite 111
Vancouver, WA 98686-6431

Phone

(360) 695-2400

Fax

(360) 906-1116

NPI assigned

May 21, 2009

Last updated

Nov 19, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Craig W Wong, DMDNPI 1841228061

Title

Owner/President

Phone

(360) 695-2400

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Craig William Wong, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Vancouver, WA
  • NPI 1841228061
  Authorized official Same address or phone

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

{
    "created_epoch": "1242864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258588800000",
    "number": "1083849913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14411 NE 20TH AVE",
            "address_2": "SUITE 111",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986866431",
            "telephone_number": "360-695-2400",
            "fax_number": "360-906-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14411 NE 20TH AVE",
            "address_2": "SUITE 111",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986866431",
            "telephone_number": "360-695-2400",
            "fax_number": "360-906-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALMON CREEK ORAL & MAXILLOFACIAL SURGERY,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-21",
        "last_updated": "2009-11-19",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "360-695-2400",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "WA5774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salmon Creek Chiropractic, LLC
• Salmon Creek Dental PLLC
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• Salmon Creek Family Practice (dba Urgent Care At Salmon Creek)
• Salmon Creek Family Practice PC (Salmon Creek Family Practice dba Urgent Care At Salmon Creek)
• Salmon Creek Oral Surgery & Periodontics
• Salmon Creek Physical Therapy P S
• Salmon Creek Plastic Surgery PC
• Salmon Creek Plastic Surgery PC
• Salmon Creek SNF Operations LLC (Salmon Creek Post Acute & Rehabilitation)

• Oral and Maxillofacial Surgery (Dentist) in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; 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.