NPIMap

Organization Active NPI

W. Curtis Mathisen D.D.S.

  • Dentist
  • White Salmon, WA
National Provider Identifier
1437389160
Registry record updated Jul 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE 00004769 Issued in WA
Legal business name
W. CURTIS MATHISEN D.D.S.
Practice address
640 N. Main St.
White Salmon, WA 98672
Phone
(509) 493-2244
Fax
(509) 493-2242
NPI assigned
Jul 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2009

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

Authorized official

Name
Dr. William Curtis Mathisen, D.D.S.
Title
Owner
Phone
(509) 493-2244

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DE 00004769 WA Primary

Addresses

Primary practice location

640 N. Main St.
White Salmon, WA 98672

Mailing address

P.O. Box 447
White Salmon, WA 98672
Phone (509) 493-2244

Other identifiers 1

IdentifierTypeStateIssuer
5536305MedicaidWA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247616000000",
    "number": "1437389160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 447",
            "city": "WHITE SALMON",
            "state": "WA",
            "postal_code": "98672",
            "telephone_number": "509-493-2244",
            "fax_number": "509-493-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 N. MAIN ST.",
            "city": "WHITE SALMON",
            "state": "WA",
            "postal_code": "98672",
            "telephone_number": "509-493-2244",
            "fax_number": "509-493-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W. CURTIS MATHISEN D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-15",
        "last_updated": "2009-07-15",
        "status": "A",
        "authorized_official_last_name": "MATHISEN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "CURTIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-493-2244",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE 00004769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5536305",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Salmon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.