Delta Dental of Washington

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Legal business name

DELTA DENTAL OF WASHINGTON

Practice address

9706 4TH Ave NE
Seattle, WA 98115-2157

Phone

(206) 528-2351

NPI assigned

May 11, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Bradley A Berg

Title

Coo & Cfo

Phone

(206) 528-2340

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Delta Dental of Washington2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Washington Dental Service

  • General Practice Dentistry
  • Seattle, WA
  • NPI 1154631117
  NPD tax ID

Locations

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462924800000",
    "number": "1174979918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9706 4TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981152157",
            "telephone_number": "206-528-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9706 4TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981152157",
            "telephone_number": "206-528-2351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA DENTAL OF WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-11",
        "last_updated": "2016-05-11",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "COO & CFO",
        "authorized_official_telephone_number": "206-528-2340",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10261666",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louis Stephen Delorie, DDS
• Shantelle Javier Delos Santos, PHARMD
• Tasha Delos Santos
• Anthony Delosreyes, DNP
• Marisa Delsignore, MD, MS
• Joan Valerie D Deluao, PT
• Delucchi LLC
• Daniel John Delucchi, D.C.
• Vitalo Delucchi
• Richard Deluga, LICSW

• Point of Service in Seattle, WA
• Providers in Seattle, WA by specialty
• Point of Service in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.