NPIMap

Organization Active NPI

Sedro Woolley Family Dental Center, P.S.

  • Dental Clinic/Center
  • Sedro Woolley, WA
National Provider Identifier
1184963845
Registry record updated Jan 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
603264506 Issued in WA
Legal business name
SEDRO WOOLLEY FAMILY DENTAL CENTER, P.S.
Practice address
830 Metcalf St
Sedro Woolley, WA 98284-1423
Phone
(360) 855-0351
Fax
(360) 855-9357
NPI assigned
Jan 31, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2013

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

Authorized official

Name
Dr. Hansrolf H Gruener, D.D.S.NPI 1457410433
Title
Owner
Phone
(360) 855-0351

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 603264506 WA Primary

Addresses

Primary practice location

830 Metcalf St
Sedro Woolley, WA 98284-1423

Mailing address

830 Metcalf St
Sedro Woolley, WA 98284-1423
Phone (360) 855-0351

National Provider Directory

National Provider Directory

Locations

830 Metcalf St
Sedro Woolley, WA 98284
Phone (360) 855-0351

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1359590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359590400000",
    "number": "1184963845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 METCALF ST",
            "city": "SEDRO WOOLLEY",
            "state": "WA",
            "postal_code": "982841423",
            "telephone_number": "360-855-0351",
            "fax_number": "360-855-9357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 METCALF ST",
            "city": "SEDRO WOOLLEY",
            "state": "WA",
            "postal_code": "982841423",
            "telephone_number": "360-855-0351",
            "fax_number": "360-855-9357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEDRO WOOLLEY FAMILY DENTAL CENTER, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-31",
        "last_updated": "2013-01-31",
        "status": "A",
        "authorized_official_last_name": "GRUENER",
        "authorized_official_first_name": "HANSROLF",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-855-0351",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "603264506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sedro Woolley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; 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.