NPIMap

Organization Active NPI

Stadium Dental

  • Dental Clinic/Center
  • Tacoma, WA
National Provider Identifier
1245910074
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
STADIUM DENTAL
Practice address
2 N Tacoma Ave
Tacoma, WA 98403-3125
Phone
(253) 383-4901
NPI assigned
Jul 18, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Authorized official

Name
Angela Samuel
Title
Office Manager
Phone
(253) 383-4901

Specialties & licenses 1

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

Addresses

Primary practice location

2 N Tacoma Ave
Tacoma, WA 98403-3125

Mailing address

2 N Tacoma Ave
Tacoma, WA 98403-3125
Phone (253) 383-4901

National Provider Directory

National Provider Directory
Tax ID family
Fme Family Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2 N Tacoma Ave
Tacoma, WA 98403
Phone (253) 383-4901

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": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689638400000",
    "number": "1245910074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 N TACOMA AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984033125",
            "telephone_number": "253-383-4901",
            "fax_number": "253-383-0631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 N TACOMA AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984033125",
            "telephone_number": "253-383-4901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STADIUM DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A",
        "authorized_official_last_name": "SAMUEL",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "253-383-4901"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

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

Verify at the official NPI Registry.