Active NPI
Sean McCombs, DDS
- General Practice Dentistry
- Vancouver, WA
National Provider Identifier
1205489051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 35493
- Practice address
- 16600 SE 15TH St
Vancouver, WA 98683-9501 - Phone
- (360) 828-7435
- NPI assigned
- Jul 22, 2019
- Last updated
- Sep 12, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 35493 | TX | Primary |
Addresses
Primary practice location
16600 SE 15TH St
Vancouver, WA 98683-9501
Mailing address
5800 N I 35 Ste 205
Denton, TX 76207-1438
Phone (903) 723-4669
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35493 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vancouver Dental LLC | Current | Accepting new patients | |
| Palestine Dental PLLC | General Practice | Past | Accepting new patients |
Locations
16600 SE 15th St
Vancouver, WA 98683
Phone (360) 828-7435
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Palestine, TX
- NPI 1174907315
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694476800000",
"number": "1205489051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5800 N I 35 STE 205",
"city": "DENTON",
"state": "TX",
"postal_code": "762071438",
"telephone_number": "903-723-4669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16600 SE 15TH ST",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986839501",
"telephone_number": "360-828-7435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCOMBS",
"first_name": "SEAN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-22",
"last_updated": "2023-09-12",
"certification_date": "2023-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "35493",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.