NPIMap

Organization Active NPI

Sammy B D Pak DDS PLLC

  • General Practice Dentistry
  • Puyallup, WA
National Provider Identifier
1235447384
Registry record updated Sep 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00008583 Issued in WA
Legal business name
SAMMY B D PAK DDS PLLC
Practice address
409 2ND St NE
Puyallup, WA 98372-3033
Phone
(253) 845-7611
Fax
(253) 845-0840
NPI assigned
Sep 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2010

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

Authorized official

Name
Dr. Sammy B D Pak, DDSNPI 1619075744
Title
Owner
Phone
(253) 845-7611

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X DE00008583 WA Primary

Addresses

Primary practice location

409 2ND St NE
Puyallup, WA 98372-3033

Mailing address

409 2ND St NE
Puyallup, WA 98372-3033
Phone (253) 845-7611

National Provider Directory

National Provider Directory

Locations

409 2nd St NE
Puyallup, WA 98372
Phone (253) 845-7611

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285113600000",
    "number": "1235447384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 2ND ST NE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723033",
            "telephone_number": "253-845-7611",
            "fax_number": "253-845-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 2ND ST NE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723033",
            "telephone_number": "253-845-7611",
            "fax_number": "253-845-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMMY B D PAK DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-22",
        "last_updated": "2010-09-22",
        "status": "A",
        "authorized_official_last_name": "PAK",
        "authorized_official_first_name": "SAMMY",
        "authorized_official_middle_name": "B D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-845-7611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00008583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; 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.