Pacific Teledentistry

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

PACIFIC TELEDENTISTRY

Practice address

2025 Fairview Ave E Unit H
Seattle, WA 98102-3575

Phone

(425) 238-5161

NPI assigned

Aug 22, 2022

Organization subpart

No

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

Authorized official

Name

Brendan Lopez

Title

Founder

Phone

(425) 238-5161

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661126400000",
    "number": "1407574791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 FAIRVIEW AVE E UNIT H",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981023575",
            "telephone_number": "425-238-5161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 FAIRVIEW AVE E UNIT H",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981023575",
            "telephone_number": "425-238-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC TELEDENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "BRENDAN",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "425-238-5161"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVING LICENSE",
            "identifier": "WDLL7R80J93B",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pacific Rehabilitation & Sports Medicine Inc
• Pacific Retina Specialists, PS
• Pacific Sleep Medicine, a Medical Corporation
• Pacific Sound Mind, PLLC
• Pacific Speech and Language Inc
• Pacific Urologic Consultants, P.S.
• Pacific Vascular Incorporated
• Pacific Vascular Incorporated
• Pacific Vascular Incorporated
• Pacific Vision Care Center, Inc., P.S.

• Health Service Clinic/Center in Seattle, WA
• Providers in Seattle, WA by specialty
• Health Service Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.