Georgia Katherine Stultz

Primary specialty

DentistTaxonomy code 122300000X

License

DENT.DE.70136594 Issued in WA

Practice address

401 S Main St
Deer Park, WA 99006-8238

Phone

(509) 444-8200

Fax

(509) 434-0392

NPI assigned

Nov 21, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1700524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1477328268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 N IRON BRIDGE WAY",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024926",
            "telephone_number": "509-444-8888",
            "fax_number": "509-444-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S MAIN ST",
            "city": "DEER PARK",
            "state": "WA",
            "postal_code": "990068238",
            "telephone_number": "509-444-8200",
            "fax_number": "509-434-0392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STULTZ",
        "first_name": "GEORGIA",
        "middle_name": "KATHERINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-21",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DENT.DE.70136594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Deer Park, WA
• Providers in Deer Park, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; 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.