NPIMap

Organization Active NPI

Washington Dental Corporation, PC

Doing business as Dentists of Convington

  • Dentist
  • Covington, WA
National Provider Identifier
1124510276
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
WASHINGTON DENTAL CORPORATION, PC
Doing business as
Dentists of Convington
Practice address
27237 172ND Ave SE Ste 105a
Covington, WA 98042-7352
Phone
(253) 263-7010
Fax
(253) 263-7010
NPI assigned
Jun 5, 2018
Last updated
Dec 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

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

Authorized official

Name
Jessica Ahn
Title
Owner
Phone
(253) 263-7010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

27237 172ND Ave SE Ste 105a
Covington, WA 98042-7352

Mailing address

PO Box 920050
Dallas, TX 75392-5626
Phone (714) 845-8890

Other names 1

  • Dentists of Convington Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Washington Dental Corporation48 organizations share this tax ID, including this one

Other organizations with this tax ID 47

Organizations that report the same tax identification number in the National Provider Directory.

View all 47

Locations

27237 172nd Ave SE
Ste 105A
Covington, WA 98042
Phone (253) 263-7010

Practitioners & affiliated clinicians

Practitioners 5

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": "1528156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703548800000",
    "number": "1124510276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753925626",
            "telephone_number": "714-845-8890",
            "fax_number": "303-952-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27237 172ND AVE SE STE 105A",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980427352",
            "telephone_number": "253-263-7010",
            "fax_number": "253-263-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON DENTAL CORPORATION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-05",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A",
        "authorized_official_last_name": "AHN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-263-7010"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentists of Convington",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Covington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; 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.