NPIMap

Organization Active NPI

Roy N. Kaldestad, DDS, PS

  • Endodontics
  • Tacoma, WA
National Provider Identifier
1154574077
Registry record updated Oct 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DE 00006323 Issued in WA
Legal business name
ROY N. KALDESTAD, DDS, PS
Practice address
1550 S Union Ave
Suite #110
Tacoma, WA 98405-1946
Phone
(253) 572-3266
Fax
(253) 572-7878
NPI assigned
Oct 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2008

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

Authorized official

Name
Dr. Roy Norman Kaldestad, DDSNPI 1790713360
Title
President
Phone
(253) 572-3266

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X DE 00006323 WA Primary

Addresses

Primary practice location

1550 S Union Ave
Suite #110
Tacoma, WA 98405-1946

Mailing address

1550 S Union Ave
Suite #110
Tacoma, WA 98405-1946
Phone (253) 572-3266

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1224720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224720000000",
    "number": "1154574077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 S UNION AVE",
            "address_2": "SUITE #110",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051946",
            "telephone_number": "253-572-3266",
            "fax_number": "253-572-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 S UNION AVE",
            "address_2": "SUITE #110",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051946",
            "telephone_number": "253-572-3266",
            "fax_number": "253-572-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROY N. KALDESTAD, DDS, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-23",
        "last_updated": "2008-10-23",
        "status": "A",
        "authorized_official_last_name": "KALDESTAD",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "NORMAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-572-3266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "DE 00006323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.