NPIMap

Organization Active NPI

Washington Dental Corporation, PC

  • General Practice Dentistry
  • Seattle, WA
National Provider Identifier
1124768460
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
WASHINGTON DENTAL CORPORATION, PC
Practice address
1732 Broadway Unit 101
Seattle, WA 98122-2621
Phone
(206) 785-1327
Fax
(206) 788-8554
NPI assigned
Apr 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Authorized official

Name
Eun Sup 'Jeff' Shin, DMD
Title
Owner
Phone
(206) 785-1327

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1732 Broadway Unit 101
Seattle, WA 98122-2621

Mailing address

PO Box 920050
Dallas, TX 75392-0050
Phone (714) 845-8890

Other names 1

  • Capitol Hill Dental Group 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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1648771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648771200000",
    "number": "1124768460",
    "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": "753920050",
            "telephone_number": "714-845-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1732 BROADWAY UNIT 101",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981222621",
            "telephone_number": "206-785-1327",
            "fax_number": "206-788-8554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON DENTAL CORPORATION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-01",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "EUN SUP 'JEFF'",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-785-1327",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capitol Hill Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; 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.