Organization Active NPI

Spokane Ambulatory Surgery Center

  • Dental Clinic/Center
  • Spokane Valley, WA
National Provider Identifier
1396820767
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SPOKANE AMBULATORY SURGERY CENTER
Practice address
12109 E Broadway Ave Ste C
Spokane Valley, WA 99206-6133
Phone
(509) 926-7106
Fax
(509) 928-7469
NPI assigned
Oct 26, 2006
Last updated
Jul 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Dr. Mark C Paxton, DDS
Title
Physician
Phone
(509) 926-7106

Specialties & licenses 1

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

Addresses

Primary practice location

12109 E Broadway Ave Ste C
Spokane Valley, WA 99206-6133

Mailing address

12109 E Broadway Ave Ste C
Spokane Valley, WA 99206-6133
Phone (509) 926-7106

Other identifiers 1

IdentifierTypeStateIssuer
7113640MedicaidWA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1396820767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12109 E BROADWAY AVE STE C",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992066133",
            "telephone_number": "509-926-7106",
            "fax_number": "509-928-7469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12109 E BROADWAY AVE STE C",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992066133",
            "telephone_number": "509-926-7106",
            "fax_number": "509-928-7469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPOKANE AMBULATORY SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "PAXTON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "509-926-7106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7113640",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.