Lisa a Block, DMD, Ms, PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

6692 Issued in WA

Legal business name

LISA A BLOCK, DMD, MS, PC

Practice address

3519 56TH St NW
Suite 140
Gig Harbor, WA 98335-8593

Phone

(253) 858-8581

Fax

(253) 858-2189

NPI assigned

Aug 12, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Lisa A Block, DMD, MS

Title

President

Phone

(253) 858-8581

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218499200000",
    "number": "1114173077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3519 56TH ST NW",
            "address_2": "SUITE 140",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983358593",
            "telephone_number": "253-858-8581",
            "fax_number": "253-858-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3519 56TH ST NW",
            "address_2": "SUITE 140",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983358593",
            "telephone_number": "253-858-8581",
            "fax_number": "253-858-2189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA A BLOCK, DMD, MS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-12",
        "last_updated": "2008-08-12",
        "status": "A",
        "authorized_official_last_name": "BLOCK",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-858-8581",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "6846",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "6692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5013925",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Gig Harbor, WA
• Providers in Gig Harbor, WA by specialty
• Pediatric Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; 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.