NPIMap

Organization Active NPI

Derek Thompson DMD Patrick Ferguson DDS, PLLC

Doing business as Apple Valley Dental & Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Yakima, WA
National Provider Identifier
1265683189
Registry record updated Oct 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
11197 Issued in WA
Legal business name
DEREK THOMPSON DMD PATRICK FERGUSON DDS, PLLC
Doing business as
Apple Valley Dental & Orthodontics
Practice address
4309 W Nob Hill Blvd
Yakima, WA 98908-3971
Phone
(509) 457-6300
Fax
(509) 248-7438
NPI assigned
Oct 9, 2008
Last updated
Oct 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2008

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

Authorized official

Name
Derek C Thompson, DMDNPI 1982822904
Title
Partenr
Phone
(509) 457-6300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9229 WA
Dentist 122300000X 10686 WA
Dentist 122300000X 8036 WA
Dentist 122300000X 3855 WA
Dentist 122300000X NU
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 11197 WA Primary

Addresses

Primary practice location

4309 W Nob Hill Blvd
Yakima, WA 98908-3971

Mailing address

4309 W Nob Hill Blvd
Yakima, WA 98908-3971
Phone (509) 457-6300

Other identifiers 5

IdentifierTypeStateIssuer
1548480072MedicaidWA
1427185826MedicaidWA
1376763813MedicaidWA
1407045875MedicaidWA
1982822904MedicaidWA

Other names 1

  • Apple Valley Dental & Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Derek Thompson DMD Patrick Ferguson DDS PLLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1223510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223510400000",
    "number": "1265683189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4309 W NOB HILL BLVD",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083971",
            "telephone_number": "509-457-6300",
            "fax_number": "509-248-7438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 W NOB HILL BLVD",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083971",
            "telephone_number": "509-457-6300",
            "fax_number": "509-248-7438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEREK THOMPSON DMD PATRICK FERGUSON DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-09",
        "last_updated": "2008-10-09",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PARTENR",
        "authorized_official_telephone_number": "509-457-6300",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "9229",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "10686",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "8036",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "3855",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "11197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548480072",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427185826",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376763813",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407045875",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982822904",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Apple Valley Dental & Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yakima, WA

Sources for this page

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