NPIMap

Organization Active NPI

Family Health Centers

  • Dental Clinic/Center
  • Bridgeport, WA
National Provider Identifier
1205253176
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
FAMILY HEALTH CENTERS
Practice address
1015 Columbia
Bridgeport, WA 98813
Phone
(509) 686-0603
Fax
(509) 686-0610
NPI assigned
Mar 27, 2014
Last updated
Jan 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Authorized official

Name
Jesus Hernandez
Title
Ceo
Phone
(509) 422-5700

Specialties & licenses 1

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

Addresses

Primary practice location

1015 Columbia
Bridgeport, WA 98813

Mailing address

PO Box 1340
Okanogan, WA 98840-1340

Other names 1

  • FHC Bridgeport Dental Other name

National Provider Directory

National Provider Directory
Tax ID family
Family Health Centers23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1205253176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1340",
            "city": "OKANOGAN",
            "state": "WA",
            "postal_code": "988401340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 COLUMBIA",
            "city": "BRIDGEPORT",
            "state": "WA",
            "postal_code": "98813",
            "telephone_number": "509-686-0603",
            "fax_number": "509-686-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-27",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JESUS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-422-5700"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FHC Bridgeport Dental",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bridgeport, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.