Advanced Family Dentistry Inc PS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE8560 Issued in WA

Legal business name

ADVANCED FAMILY DENTISTRY INC PS

Doing business as

Advanced Family Dentistry

Practice address

20101 44TH Ave West
Suite G
Lynnwood, WA 98036-6745

Phone

(425) 640-0207

Fax

(425) 640-0571

NPI assigned

Oct 12, 2006

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

Romanine Loch, DMD

Title

President

Phone

(425) 640-0207

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Advanced Family Dentistry Doing business as

Locations

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487743985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20101 44TH AVE WEST",
            "address_2": "SUITE G",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366745",
            "telephone_number": "425-640-0207",
            "fax_number": "425-640-0571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20101 44TH AVE WEST",
            "address_2": "SUITE G",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366745",
            "telephone_number": "425-640-0207",
            "fax_number": "425-640-0571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FAMILY DENTISTRY INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOCH",
        "authorized_official_first_name": "ROMANINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-640-0207",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE8560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5034335",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Lynnwood, WA
• Providers in Lynnwood, 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.