Individual provider Active NPI

Daniel R Dorsey, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Vancouver, WA
National Provider Identifier
1225134497
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
5410 Issued in WA
Practice address
300 SE 120TH Ave
Suite 600
Vancouver, WA 98683-4090
Phone
(360) 260-3290
Fax
(360) 260-3291
NPI assigned
Sep 15, 2006
Last updated
Feb 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 5410 WA Primary

Addresses

Primary practice location

300 SE 120TH Ave
Suite 600
Vancouver, WA 98683-4090

Mailing address

1300 Esther St
#100
Vancouver, WA 98660-2889
Phone (360) 695-9248

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

LicenseStateTypeSpecialty
5410WAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Vancouver Oral Surgery Group PastSince Jul 1, 1993 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1225134497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 ESTHER ST",
            "address_2": "#100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986602889",
            "telephone_number": "360-695-9248",
            "fax_number": "360-695-9249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SE 120TH AVE",
            "address_2": "SUITE 600",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986834090",
            "telephone_number": "360-260-3290",
            "fax_number": "360-260-3291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORSEY",
        "first_name": "DANIEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "5410",
            "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 Feb 19, 2008; 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.