NPIMap

Organization Active NPI

George C. Brain DDS PC

  • Pediatric Dentistry
  • Tacoma, WA
National Provider Identifier
1174617781
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DE00003551 Issued in WA
Legal business name
GEORGE C. BRAIN DDS PC
Practice address
1901 S Union Ave
Suite B-3008
Tacoma, WA 98405-1702
Phone
(253) 572-9777
Fax
(253) 627-6766
NPI assigned
Oct 3, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Lorie Anne Ramsdell
Title
Office Manager
Phone
(253) 572-9777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DE00003551 WA Primary

Addresses

Primary practice location

1901 S Union Ave
Suite B-3008
Tacoma, WA 98405-1702

Mailing address

1901 S Union Ave
Suite B-3008
Tacoma, WA 98405-1702
Phone (253) 572-9777

Other identifiers 1

IdentifierTypeStateIssuer
5031455MedicaidWA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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": "1174617781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 S UNION AVE",
            "address_2": "SUITE B-3008",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051702",
            "telephone_number": "253-572-9777",
            "fax_number": "253-627-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 S UNION AVE",
            "address_2": "SUITE B-3008",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051702",
            "telephone_number": "253-572-9777",
            "fax_number": "253-627-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE C. BRAIN DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAMSDELL",
        "authorized_official_first_name": "LORIE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "253-572-9777",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE00003551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5031455",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • 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.