NPIMap

Organization Active NPI

Green Dentistry

  • Dental Clinic/Center
  • Des Moines, WA
National Provider Identifier
1376028589
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
GREEN DENTISTRY
Practice address
23040 Pacific Hwy S Ste 311
Des Moines, WA 98198-7268
Phone
(206) 878-3111
NPI assigned
Oct 3, 2018
Last updated
Oct 3, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Authorized official

Name
Amritpal Mattu, DDSNPI 1285180513
Title
Dentist
Phone
(425) 753-1163

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

23040 Pacific Hwy S Ste 311
Des Moines, WA 98198-7268

Mailing address

23040 Pacific Hwy S Ste 311
Des Moines, WA 98198-7268
Phone (206) 878-3111

National Provider Directory

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": "1538524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538524800000",
    "number": "1376028589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23040 PACIFIC HWY S STE 311",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981987268",
            "telephone_number": "206-878-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23040 PACIFIC HWY S STE 311",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981987268",
            "telephone_number": "206-878-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-03",
        "last_updated": "2018-10-03",
        "status": "A",
        "authorized_official_last_name": "MATTU",
        "authorized_official_first_name": "AMRITPAL",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "425-753-1163",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2018; 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.