Belle Vista Denture Clinic, PLLC

Primary specialty

DenturistTaxonomy code 122400000X

Legal business name

BELLE VISTA DENTURE CLINIC, PLLC

Practice address

3609 W Nob Hill Blvd
Suite 103
Yakima, WA 98902-4744

Phone

(509) 786-2963

Fax

(888) 656-9322

NPI assigned

Aug 19, 2007

Organization subpart

No

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

Authorized official

Name

Joshua D Brooks

Title

Sole Member

Phone

(509) 786-2963

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bella Vista Denture Clinic, PLLC Doing business as

Locations

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

{
    "created_epoch": "1187481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187481600000",
    "number": "1104019660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 MEADE AVE",
            "city": "PROSSER",
            "state": "WA",
            "postal_code": "993501423",
            "telephone_number": "509-786-2963",
            "fax_number": "888-656-9322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3609 W NOB HILL BLVD",
            "address_2": "SUITE 103",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989024744",
            "telephone_number": "509-786-2963",
            "fax_number": "888-656-9322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLE VISTA DENTURE CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-19",
        "last_updated": "2007-08-19",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "509-786-2963"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Denturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5049218",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bella Vista Denture Clinic, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Denturist in Yakima, WA
• Providers in Yakima, WA by specialty
• Denturist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2007; 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.