NPIMap

Organization Active NPI

Community Health Center of Snohomish County

  • Dentist
  • Everett, WA
National Provider Identifier
1164553137
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5010921 Issued in WA
Legal business name
COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY
Practice address
2722 Colby Ave
Suite 318
Everett, WA 98201-3557
Phone
(425) 551-1000
Fax
(425) 551-1001
NPI assigned
Mar 8, 2007
Organization subpart
Yes
Parent organization
COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Authorized official

Name
Mr. Kenneth M Green
Title
Executive Director
Phone
(425) 789-3700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 5010921 WA Primary

Addresses

Primary practice location

2722 Colby Ave
Suite 318
Everett, WA 98201-3557

Mailing address

PO Box 13060
Everett, WA 98206-3060
Phone (425) 789-3700

Other identifiers 3

IdentifierTypeStateIssuer
5010921MedicaidWA
8934243OtherWACRIME VICTIM COMPENSATION
32770OtherWAWORKMEN COMPENSATION

Other names 1

  • Community Health Center of Snohomish County Colby Dental Other name

National Provider Directory

National Provider Directory
Tax ID family
Community Health Center28 organizations share this tax ID, including this one
Part of
Community Health Center

Other organizations with this tax ID 27

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

View all 27

Locations

2722 Colby Ave
Ste 318
Everett, WA 98201
Phone (425) 551-1000

Practitioners & affiliated clinicians

Practitioners 7

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": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1164553137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13060",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982063060",
            "telephone_number": "425-789-3700",
            "fax_number": "425-789-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2722 COLBY AVE",
            "address_2": "SUITE 318",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013557",
            "telephone_number": "425-551-1000",
            "fax_number": "425-551-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HEALTH CENTER OF SNOHOMISH COUNTY",
        "enumeration_date": "2007-03-08",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "425-789-3700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "5010921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5010921",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIM COMPENSATION",
            "identifier": "8934243",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKMEN COMPENSATION",
            "identifier": "32770",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Health Center of Snohomish County Colby Dental",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.