NPIMap

Organization Active NPI

Bellingham Family Dentistry

  • Dental Clinic/Center
  • Bellingham, WA
National Provider Identifier
1114261187
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DE00010175 Issued in WA
Legal business name
BELLINGHAM FAMILY DENTISTRY
Practice address
3628 Meridian St Ste 1C
Bellingham, WA 98225-1735
Phone
(360) 733-5400
Fax
(360) 715-9196
NPI assigned
Nov 15, 2012
Last updated
Nov 15, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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

Authorized official

Name
Michael R Jorgenson, DDS
Title
Owner
Phone
(360) 733-5400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DE00010175 WA Primary

Addresses

Primary practice location

3628 Meridian St Ste 1C
Bellingham, WA 98225-1735

Mailing address

3628 Meridian St Ste 1C
Bellingham, WA 98225-1735
Phone (360) 733-5400

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1114261187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3628 MERIDIAN ST STE 1C",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251735",
            "telephone_number": "360-733-5400",
            "fax_number": "360-715-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3628 MERIDIAN ST STE 1C",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251735",
            "telephone_number": "360-733-5400",
            "fax_number": "360-715-9196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLINGHAM FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "JORGENSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-733-5400",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "DE00010175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.