NPIMap

Organization Active NPI

Community Health of Central Washington

  • Dental Clinic/Center
  • Ellensburg, WA
National Provider Identifier
1376878769
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
COMMUNITY HEALTH OF CENTRAL WASHINGTON
Practice address
521 E Mountain View Ave
Ellensburg, WA 98926-3865
Phone
(509) 933-4800
Fax
(509) 933-4802
NPI assigned
Oct 2, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Authorized official

Name
Angela Gonzalez
Title
Ceo
Phone
(509) 494-6700

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X
Dental Clinic/Center 261QD0000X Primary
Federally Qualified Health Center (FQHC) 261QF0400X
Student Health Clinic/Center 261QS1000X

Addresses

Primary practice location

521 E Mountain View Ave
Ellensburg, WA 98926-3865

Mailing address

501 S 5TH Ave
Yakima, WA 98902-3550
Phone (509) 494-6700

Other practice location 1

4244 Bullfrog Rd
Cle Elum, WA 98922-8717
Phone (509) 933-2400

Other identifiers 1

IdentifierTypeStateIssuer
7118276MedicaidWA

Other names 1

  • Ellensburg Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Health of Central14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

4244 Bullfrog Rd
Cle Elum, WA 98922
Phone (509) 933-2400

1206 N Dolarway Rd
Ste 101
Ellensburg, WA 98926
Phone (509) 933-2400

521 E Mountain View Ave
Ste A
Ellensburg, WA 98926

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1254441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1376878769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S 5TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023550",
            "telephone_number": "509-494-6700",
            "fax_number": "509-573-6275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 E MOUNTAIN VIEW AVE",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263865",
            "telephone_number": "509-933-4800",
            "fax_number": "509-933-4802"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4244 Bullfrog Rd",
            "address_purpose": "LOCATION",
            "city": "Cle Elum",
            "state": "WA",
            "postal_code": "989228717",
            "country_code": "US",
            "telephone_number": "509-933-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY HEALTH OF CENTRAL WASHINGTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-02",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-494-6700"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7118276",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ellensburg Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ellensburg Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellensburg, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.