Pacific Northwest Dental Group, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PACIFIC NORTHWEST DENTAL GROUP, LLC

Practice address

2728 Westmoor CT SW Ste D
Olympia, WA 98502-5779

Phone

(360) 995-0025

Fax

(360) 995-0027

NPI assigned

Mar 18, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Chad Kleven, DDSNPI 1013128438

Title

Owner

Phone

(360) 995-0025

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chad L Kleven, D.D.S.

  • Dentist
  • Longview, WA
  • NPI 1013128438
  NPD Authorized official
• Sanghamitra Suman

  • Dentist
  • Olympia, WA
  • NPI 1407588684
  NPD
• Eric Chengyu Xu, DDS

  • Dentist
  • Olympia, WA
  • NPI 1083393466
  NPD

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

{
    "created_epoch": "1616025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616025600000",
    "number": "1205412467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 11TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2728 WESTMOOR CT SW STE D",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025779",
            "telephone_number": "360-995-0025",
            "fax_number": "360-995-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC NORTHWEST DENTAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-18",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A",
        "authorized_official_last_name": "KLEVEN",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-995-0025",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Pace, ARNP
• Kaila Pacheco
• Petya Pacheva, MA, LMHC, CDP, MHP
• Pacific Behavioral Health & Wellness
• Pacific Medical, Inc.
• Pacific Northwest Eye Care, PS (Pacific Northwest Eye Care)
• Pacific Northwest Eye Care, PS (Pacific Northwest Eye Care)
• Pacific Northwest Psychological Services and Consulting
• Pacific Speech and Neurological Rehabilitation, PLLC (Pacific Speech and Neuro Rehab)
• Pacific Surgical Weight Loss Center, PLLC

• Dental Clinic/Center in Olympia, WA
• Providers in Olympia, WA by specialty
• Dental Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.