NPIMap

Organization Active NPI

Kitsap Dental

  • Dental Clinic/Center
  • Poulsbo, WA
National Provider Identifier
1194223537
Registry record updated Jan 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
60080602 Issued in WA
Legal business name
KITSAP DENTAL
Practice address
20730 Bond Rd NE Ste 100
Poulsbo, WA 98370-9000
Phone
(360) 779-2420
Fax
(360) 779-6219
NPI assigned
Jan 31, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2018

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

Authorized official

Name
Lois Lee, DDS
Title
Dentist
Phone
(360) 779-2420

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 60080602 WA Primary

Addresses

Primary practice location

20730 Bond Rd NE Ste 100
Poulsbo, WA 98370-9000

Mailing address

20730 Bond Rd NE Ste 100
Poulsbo, WA 98370-9000
Phone (360) 779-2420

Other identifiers 1

IdentifierTypeStateIssuer
60080602OtherWALICENSE NUMBER

National Provider Directory

National Provider Directory

Locations

20730 Bond Rd NE
Ste 100
Poulsbo, WA 98370
Phone (360) 779-2420

NPI Registry JSON

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517356800000",
    "number": "1194223537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20730 BOND RD NE STE 100",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983709000",
            "telephone_number": "360-779-2420",
            "fax_number": "360-779-6219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20730 BOND RD NE STE 100",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983709000",
            "telephone_number": "360-779-2420",
            "fax_number": "360-779-6219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KITSAP DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-31",
        "last_updated": "2018-01-31",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "LOIS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "360-779-2420",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "60080602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "60080602",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poulsbo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; 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.