South Sound Family Dentistry, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9986 Issued in WA

Legal business name

SOUTH SOUND FAMILY DENTISTRY, PLLC

Practice address

703 Lilly Rd NE Ste 201
Olympia, WA 98506-5256

Phone

(360) 459-3400

NPI assigned

Dec 18, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Levi G Green, DDSNPI 1033277942

Title

President

Phone

(360) 459-3400

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• South Sound Family Dentistry Other name

Locations

Practitioners 2

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

• Levi G Green, DDS

  • General Practice Dentistry
  • Olympia, WA
  • NPI 1033277942
  NPD (past) Authorized official
• Althea Ann Acosta, DDS

  • Student in an Organized Health Care Education/Training Program
  • Gainesville, FL
  • NPI 1215369673
  NPD (past)

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461024000000",
    "number": "1164585634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 LILLY RD NE STE 201",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065256",
            "telephone_number": "360-459-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 LILLY RD NE STE 201",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065256",
            "telephone_number": "360-459-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SOUND FAMILY DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2016-04-19",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "LEVI",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-459-3400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00009986",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "9986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I GROUP PROVIDER #",
            "identifier": "0215386",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Sound Family Dentistry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• South Sound Community College
• South Sound Dentures, P.S.
• South Sound Dentures,PS
• South Sound Family & Sports
• South Sound Family Dentistry
• South Sound Health & Fitness
• South Sound Inpatient Physicians PLLC
• South Sound Internal Medicine PLLC
• South Sound Medical Group, PLLC
• South Sound Neuropsychology Inc.

• General Practice Dentistry in Olympia, WA
• Providers in Olympia, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; 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.