Penny C Walpole DDS PS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE7995 Issued in WA

Legal business name

PENNY C WALPOLE DDS PS

Practice address

15701 E Sprague Ave
Ste F
Veradale, WA 99037

Phone

(509) 922-4809

Fax

(509) 922-8718

NPI assigned

Jul 1, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Penny C Walpole, DDS PS

Title

President

Phone

(509) 922-4809

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376572511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15701 E SPRAGUE AVE",
            "address_2": "STE F",
            "city": "VERADALE",
            "state": "WA",
            "postal_code": "99037",
            "telephone_number": "509-922-4809",
            "fax_number": "509-922-8718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15701 E SPRAGUE AVE",
            "address_2": "STE F",
            "city": "VERADALE",
            "state": "WA",
            "postal_code": "99037",
            "telephone_number": "509-922-4809",
            "fax_number": "509-922-8718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNY C WALPOLE DDS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALPOLE",
        "authorized_official_first_name": "PENNY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-922-4809",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS  PS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE7995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cardinal Family Services
• Renai Elizabeth Durst, PRESIDENT
• Shana L Gaunt, MSW, LICSWA, MHP
• Charla Jones
• Kenneth W Mankins, LMHC
• Precious Cargo Washington, Inc.

• General Practice Dentistry in Veradale, WA
• Providers in Veradale, 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 22, 2020; 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.