Dental Care Burlington Wa

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DENTAL CARE BURLINGTON WA

Practice address

103 E Hazel Ave
Burlington, WA 98233

Phone

(360) 755-0057

Fax

(360) 755-9828

NPI assigned

Oct 8, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Eduard Gennadiavich Skachkov, DDSNPI 1326421769

Title

Owner

Phone

(360) 755-0057

Specialties & licenses 2

Addresses

Other names 1

• Eduard Skachkov DDS PLLC Former legal business name

Locations

Practitioners 2

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

• Eduard Gennadiarich Skachkov, DDS

  • General Practice Dentistry
  • Burlington, WA
  • NPI 1326421769
  NPD Authorized official
• Michael C Eubanks, D.M.D.

  • General Practice Dentistry
  • Burlington, WA
  • NPI 1871712588
  NPD (past)

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

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723161600000",
    "number": "1255093050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 E HAZEL AVE",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "98233",
            "telephone_number": "360-755-0057",
            "fax_number": "360-755-9828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 E HAZEL AVE",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "98233",
            "telephone_number": "360-755-0057",
            "fax_number": "360-755-9828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL CARE BURLINGTON WA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-08",
        "last_updated": "2024-08-09",
        "certification_date": "2021-10-08",
        "status": "A",
        "authorized_official_last_name": "SKACHKOV",
        "authorized_official_first_name": "EDUARD",
        "authorized_official_middle_name": "GENNADIAVICH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-755-0057",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eduard Skachkov DDS PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Dana Dardis, M.ED. SUDPT
• David Gage DMD PLLC
• Amanda K. De Vries, LMP
• Laura Ellen Defreese, BS
• Alice Dellisanti, D.D.S.
• John Francis Dickey, CP60426031
• Michael R Dillard, MD
• Stephanie R Dodd
• Julie Anna Doster Dodge, LMHC, ATR-P, MA
• Sara Dossen, RN

• General Practice Dentistry in Burlington, WA
• Providers in Burlington, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.