St. Anthony'S Family Dentistry, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

5841 Issued in WA

Legal business name

ST. ANTHONY'S FAMILY DENTISTRY, LLC

Practice address

11511 Canterwood Blvd NW
Ste. 120
Gig Harbor, WA 98332-5813

Phone

(253) 857-2483

NPI assigned

Dec 10, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Mark D. Johnson, DDS

Title

President

Phone

(253) 857-2483

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260403200000",
    "number": "1386973964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 CANTERWOOD BLVD NW",
            "address_2": "STE. 120",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983325813",
            "telephone_number": "253-857-2483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11511 CANTERWOOD BLVD NW",
            "address_2": "STE. 120",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983325813",
            "telephone_number": "253-857-2483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ANTHONY'S FAMILY DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-10",
        "last_updated": "2009-12-10",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-857-2483",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "5841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Joy Spaulding, D.D.S.
• Sean Benjamin Spaulding, D.C.
• Speech Matters Corp
• Lauren Nicole-Trittin Spencer, MS, LMFTA
• Susan H Sporl, MSW
• Valerie C St. John, M.SC.
• Cassandra Leigh St. Martin, LMT, DPT
• Matthew John Stadler, D.D.S.
• Cynnette Stanke, RBT
• Seth J. Stankus, D.O.

• Dentist in Gig Harbor, WA
• Providers in Gig Harbor, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; 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.