NPIMap

Organization Active NPI

Bock and Hutchinson, PLLC

  • General Practice Dentistry
  • Port Orchard, WA
National Provider Identifier
1144570003
Registry record updated Sep 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9039 Issued in WA
Legal business name
BOCK AND HUTCHINSON, PLLC
Practice address
1953 Pottery Ave
Port Orchard, WA 98366-2558
Phone
(360) 876-6211
Fax
(360) 876-7952
NPI assigned
Sep 18, 2012
Last updated
Sep 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2012

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

Authorized official

Name
Mrs. Susan Lynn Bock
Title
Administrative Assistant
Phone
(360) 876-6211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9039 WA Primary

Addresses

Primary practice location

1953 Pottery Ave
Port Orchard, WA 98366-2558

Mailing address

1953 Pottery Ave
Port Orchard, WA 98366-2558
Phone (360) 876-6211

Other identifiers 1

IdentifierTypeStateIssuer
12230000XMedicaidWA

Other names 1

  • South Kitsap Family Dentistry Other name

National Provider Directory

National Provider Directory

Locations

1953 Pottery Ave
Port Orchard, WA 98366
Phone (360) 876-6211

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": "1347926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347926400000",
    "number": "1144570003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1953 POTTERY AVE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983662558",
            "telephone_number": "360-876-6211",
            "fax_number": "360-876-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1953 POTTERY AVE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983662558",
            "telephone_number": "360-876-6211",
            "fax_number": "360-876-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOCK AND HUTCHINSON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-18",
        "last_updated": "2012-09-18",
        "status": "A",
        "authorized_official_last_name": "BOCK",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "360-876-6211",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "9039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12230000X",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Kitsap Family Dentistry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.