Pacific Childrens Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

9397 Issued in WA

Legal business name

PACIFIC CHILDRENS DENTISTRY

Practice address

916 Pacific Ave
Everett, WA 98201-4147

Phone

(206) 355-1596

NPI assigned

Jan 3, 2012

Organization subpart

No

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

Authorized official

Name

Tarja KaakkoNPI 1306911383

Title

President

Phone

(206) 355-1596

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Tarja Kaakko

  • Pediatric Dentistry
  • Issaquah, WA
  • NPI 1306911383
  NPD (past) Authorized official

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

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325548800000",
    "number": "1407126873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 NW GILMAN BLVD",
            "address_2": "E-103, #493",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 PACIFIC AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014147",
            "telephone_number": "206-355-1596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CHILDRENS DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-03",
        "last_updated": "2012-01-03",
        "status": "A",
        "authorized_official_last_name": "KAAKKO",
        "authorized_official_first_name": "TARJA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "206-355-1596"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "9397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI 1306911383",
            "identifier": "1306911383",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5056239",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Owens
• Audrey Rosleyne Akinyi Owuor
• Victoria Oxford, LICSW
• Kelsy Ozuna, MSW
• Erin Paavola, LMHC PHD
• Pacific Kidney & Hypertension, LLC
• Pacific Northwest Christian Counseling PLLC
• Pacific Northwest Dental
• Leon Packer
• Marianela Packer

• Pediatric Dentistry in Everett, WA
• Providers in Everett, WA by specialty
• Pediatric Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; 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.