Individual provider Active NPI

Gideon Michael Arnett, DMD

  • General Practice Dentistry
  • Woodland, WA
National Provider Identifier
1417565672
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE61071268 Issued in WA
Practice address
500 Columbia St Ste B
Woodland, WA 98674-8491
Phone
(360) 225-5600
NPI assigned
Jul 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE61071268 WA Primary

Addresses

Primary practice location

500 Columbia St Ste B
Woodland, WA 98674-8491

Mailing address

1312 S Sevier Rd
Ridgefield, WA 98642-7692
Phone (360) 949-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DE61071268WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Gideon M Arnett, DMD, P.L.L.C. General Practice Current Accepting new patients
Gideon M Arnett, DMD, P.L.L.C. CurrentSince Aug 25, 2024 Accepting new patients
J. Blake Perkins, DDS, PS PastSince Jul 1, 2020 Accepting new patients
J.Blake Perkins D.D.S. P.S. PastSince Jul 1, 2020 Accepting new patients

Locations

500 Columbia St
Ste B
Woodland, WA 98674
Phone (360) 225-5600

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1417565672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 S SEVIER RD",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "986427692",
            "telephone_number": "360-949-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 COLUMBIA ST STE B",
            "city": "WOODLAND",
            "state": "WA",
            "postal_code": "986748491",
            "telephone_number": "360-225-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNETT",
        "first_name": "GIDEON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-14",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61071268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.