Individual provider Active NPI

Scott Wampole, D.D.S., M.S.

  • Periodontics
  • Lakewood, WA
National Provider Identifier
1346334950
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DE6814 Issued in WA
Practice address
5920 100TH St. S.W.
Ste. 27
Lakewood, WA 98499-2751
Phone
(253) 589-1101
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DE6814 WA Primary
Periodontics 1223P0300X 34253 CA

Addresses

Primary practice location

5920 100TH St. S.W.
Ste. 27
Lakewood, WA 98499-2751

Mailing address

5920 100TH St. S.W.
Ste. 27
Lakewood, WA 98499-2751
Phone (253) 589-1101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
34253CAMDPeriodontist
DE6814WAMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346334950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 100TH ST. S.W.",
            "address_2": "STE. 27",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984992751",
            "telephone_number": "253-589-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 100TH ST. S.W.",
            "address_2": "STE. 27",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984992751",
            "telephone_number": "253-589-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAMPOLE",
        "first_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": "DE6814",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "34253",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.