NPIMap

Organization Active NPI

Pacific Highway Dental Associates

  • General Practice Dentistry
  • Kent, WA
National Provider Identifier
1285951327
Registry record updated Apr 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00007305 Issued in WA
Legal business name
PACIFIC HIGHWAY DENTAL ASSOCIATES
Practice address
27020 Pacific Hwy S
Suite C
Kent, WA 98032-6951
Phone
(253) 529-9434
NPI assigned
Apr 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2010

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

Authorized official

Name
Dr. Charles Henry Pan, D.D.S.
Title
President
Phone
(253) 529-9434

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DE00007305 WA Primary

Addresses

Primary practice location

27020 Pacific Hwy S
Suite C
Kent, WA 98032-6951

Mailing address

27020 Pacific Hwy S
Suite C
Kent, WA 98032-6951
Phone (253) 529-9434

Other identifiers 1

IdentifierTypeStateIssuer
5022967MedicaidWA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272499200000",
    "number": "1285951327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27020 PACIFIC HWY S",
            "address_2": "SUITE C",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980326951",
            "telephone_number": "253-529-9434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27020 PACIFIC HWY S",
            "address_2": "SUITE C",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980326951",
            "telephone_number": "253-529-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC HIGHWAY DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-29",
        "last_updated": "2010-04-29",
        "status": "A",
        "authorized_official_last_name": "PAN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-529-9434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00007305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5022967",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.