NPIMap

Organization Active NPI

Innovative Endodontic Solutions

  • Endodontics
  • Duvall, WA
National Provider Identifier
1376918342
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DE60566900 Issued in WA
Legal business name
INNOVATIVE ENDODONTIC SOLUTIONS
Practice address
26504 NE Valley Street
Duvall, WA 98019
Phone
(425) 788-9575
Fax
(425) 788-9577
NPI assigned
Dec 2, 2015
Last updated
Dec 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2015

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

Authorized official

Name
Cynthia Rebecca Tyler, DDSNPI 1407134919
Title
Endodontist
Phone
(206) 930-8789

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
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X DE60566900 WA Primary

Addresses

Primary practice location

26504 NE Valley Street
Duvall, WA 98019

Mailing address

PO Box 1180
Duvall, WA 98019-1180
Phone (425) 788-9575

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1449014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449014400000",
    "number": "1376918342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1180",
            "city": "DUVALL",
            "state": "WA",
            "postal_code": "980191180",
            "telephone_number": "425-788-9575",
            "fax_number": "425-788-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26504 NE VALLEY STREET",
            "city": "DUVALL",
            "state": "WA",
            "postal_code": "98019",
            "telephone_number": "425-788-9575",
            "fax_number": "425-788-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE ENDODONTIC SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-02",
        "last_updated": "2015-12-02",
        "status": "A",
        "authorized_official_last_name": "TYLER",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "REBECCA",
        "authorized_official_title_or_position": "ENDODONTIST",
        "authorized_official_telephone_number": "206-930-8789",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "DE60566900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duvall, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; 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.