Anzi Dental Center 3

Primary specialty

DentistTaxonomy code 122300000X

License

8264 Issued in WA

Legal business name

ANZI DENTAL CENTER 3

Practice address

4202 10TH St SE
#102
Puyallup, WA 98374

Phone

(253) 434-4401

Fax

(253) 435-4404

NPI assigned

Mar 28, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rosa Maria Cortesi

Title

Ofice Manager

Phone

(253) 435-4401

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457470882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4202 10TH ST SE",
            "address_2": "SUITE 102",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "98374",
            "telephone_number": "253-434-4401",
            "fax_number": "253-435-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4202 10TH ST SE",
            "address_2": "#102",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "98374",
            "telephone_number": "253-434-4401",
            "fax_number": "253-435-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANZI DENTAL CENTER 3",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CORTESI",
        "authorized_official_first_name": "ROSA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "OFICE MANAGER",
        "authorized_official_telephone_number": "253-435-4401"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "8264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fidelis Ronny Ansah
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• Dentist in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.