Ojh Clinic No 1 Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5262

Legal business name

OJH CLINIC NO 1 INC

Practice address

17224 SE 272ND Street
Covington, WA 98042

Phone

(253) 630-4400

Fax

(253) 631-2267

NPI assigned

May 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Otto J Hanssen, DDS

Title

Dentist Owner

Phone

(253) 630-4400

Specialties & licenses 1

Addresses

Other names 1

• Covington Family Dentistry Other name

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477767333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17224 SE 272ND STREET",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "98042",
            "telephone_number": "253-630-4400",
            "fax_number": "253-631-2267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17224 SE 272ND STREET",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "98042",
            "telephone_number": "253-630-4400",
            "fax_number": "253-631-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OJH CLINIC NO 1 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HANSSEN",
        "authorized_official_first_name": "OTTO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "253-630-4400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": "5262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covington Family Dentistry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• General Practice Dentistry in Covington, WA
• Providers in Covington, WA by specialty
• General Practice Dentistry 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.