Columbia Endodontic Group, P.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

COLUMBIA ENDODONTIC GROUP, P.S.

Practice address

5015 NE St. Johns Road
Vancouver, WA 98661

Phone

(360) 699-1101

Fax

(360) 695-3152

NPI assigned

Oct 3, 2006

Last updated

Aug 22, 2020By 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

David Akio Kosa, D.D.S.NPI 1497978852

Title

Treasurer

Phone

(360) 699-1101

Specialties & licenses 1

Addresses

Other names 1

• Ardon L. Overby, DMD and David S. Mehlhaff, DMD Former legal business name

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David A Kosa, DDS

  • Endodontics
  • Vancouver, WA
  • NPI 1497978852
  NPD (past) Authorized official
• J. Gordon Marshall, DMD

  • Endodontics
  • Vancouver, WA
  • NPI 1841413242
  NPD (past)
• David S Mehlhaff, DMD

  • Endodontics
  • Vancouver, WA
  • NPI 1083837470
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174617724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5015 NE ST. JOHNS ROAD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98661",
            "telephone_number": "360-699-1101",
            "fax_number": "360-695-3152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 NE ST. JOHNS ROAD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98661",
            "telephone_number": "360-699-1101",
            "fax_number": "360-695-3152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA ENDODONTIC GROUP, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOSA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "AKIO",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "360-699-1101",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ardon L. Overby, DMD and David S. Mehlhaff, DMD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Sarah Kathleen Collum, LMP
• Daniel Jay Colon, MSW, MHP
• Tamara Sue Colpitts
• Justin Colquhoun, PA-C
• Columbia Anesthesia Group P S
• Columbia Eyecare PC
• Columbia Eyecare PC
• Columbia Foot and Ankle Clinic-Virgil Gene Livinston
• Columbia Foot and Ankle Clinic, LLC
• Columbia Foot and Ankle Clinic, LLC

• Endodontics in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Endodontics in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.