Preventec

Primary specialty

DentistTaxonomy code 122300000X

License

DE00008414 Issued in FL

Legal business name

PREVENTEC

Practice address

7701 W 4TH Ave Apt E104
Kennewick, WA 99336-8540

Phone

(509) 783-1094

Fax

(509) 392-7150

NPI assigned

Aug 19, 2013

Last updated

Aug 19, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Larry Burnett, DDS

Title

Owner

Phone

(509) 783-1094

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376870400000",
    "number": "1154754612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7701 W 4TH AVE APT E104",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993368540",
            "telephone_number": "509-783-1094",
            "fax_number": "509-392-7150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7701 W 4TH AVE APT E104",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993368540",
            "telephone_number": "509-783-1094",
            "fax_number": "509-392-7150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTEC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-19",
        "last_updated": "2013-08-19",
        "status": "A",
        "authorized_official_last_name": "BURNETT",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-783-1094",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DE00008414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Kennewick, WA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.