NPIMap

Organization Active NPI

Washington Dental Corporation, PC

  • Dentist
  • Seattle, WA
National Provider Identifier
1154862761
Registry record updated Apr 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
WASHINGTON DENTAL CORPORATION, PC
Practice address
2326 5TH Ave
Seattle, WA 98121
Phone
(206) 494-9050
Fax
(206) 438-3863
NPI assigned
Mar 15, 2017
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Brian R Polillo, DDS
Title
Owner
Phone
(206) 494-9050

Corporate family (same tax ID) 47

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

View all 47

Practitioners 7

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

National Provider Directory

National Provider Directory
Tax ID family
Washington Dental Corporation (48 organizations share this tax ID)

Locations

2326 5th Ave
Seattle, WA 98121
Phone (206) 494-9050

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

2326 5TH Ave
Seattle, WA 98121

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8890

Other names 1

NPPES NPI Registry
  • Belltown Modern Dentistry Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 10, 2017.

{
    "created_epoch": "1489536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491782400000",
    "number": "1154862761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2326 5TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98121",
            "telephone_number": "206-494-9050",
            "fax_number": "206-438-3863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON DENTAL CORPORATION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-15",
        "last_updated": "2017-04-10",
        "status": "A",
        "authorized_official_last_name": "POLILLO",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-494-9050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Belltown Modern Dentistry",
            "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 10, 2017; 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.