Sandra D Phillips, DH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

DH00007167 Issued in WA

Practice address

800 West Maple Street
Medical Lake, WA 99022-0800

Phone

(509) 565-4000

Fax

(509) 565-7015

NPI assigned

Jan 20, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Department of Social Dept of SHS Div of Instns

  dba Eastern State Hospital

  • Psychiatric Hospital
  • Medical Lake, WA
  • NPI 1467440602
  NPD (past)
• Eastern State Hospital Pharmacy

  • Long Term Care Pharmacy
  • Medical Lake, WA
  • NPI 1679651970
  NPD (past)

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

{
    "created_epoch": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1184955874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 800",
            "address_2": "800 WEST MAPLE STREET",
            "city": "MEDICAL LAKE",
            "state": "WA",
            "postal_code": "990220800",
            "telephone_number": "509-565-4000",
            "fax_number": "509-565-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WEST MAPLE STREET",
            "city": "MEDICAL LAKE",
            "state": "WA",
            "postal_code": "990220800",
            "telephone_number": "509-565-4000",
            "fax_number": "509-565-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "SANDRA",
        "middle_name": "D",
        "credential": "DH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-20",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WA",
            "license": "DH00007167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL HYGIENE LICENSE",
            "identifier": "DH00007167",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven W. Palmieri, PHD, D.O.
• Taylor Pecknold, MS, RDN, CD
• Amanda Peek
• Suzanne D. Peregoy, D.O.
• Milton J Petrin
• Cynthia Jean Pierce, PHARMD
• Timothy J Pinnell
• James P Purvis, DDS
• Ashley Nicole Ramsdale, PSYD
• Regenerative Medicine Institute, PLLC

• Dental Hygienist in Medical Lake, WA
• Providers in Medical Lake, WA by specialty
• Dental Hygienist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; 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.