Organization Active NPI

Bruce C Toillion

  • Dentist
  • Medical Lake, WA
National Provider Identifier
1497077986
Registry record updated Feb 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4735 Issued in WA
Legal business name
BRUCE C TOILLION
Practice address
N 123 Brower
Medical Lake, WA 99022
Phone
(509) 299-5171
Fax
(509) 299-5151
NPI assigned
Feb 24, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2010

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

Authorized official

Name
Bruce C Toillion, DDS
Title
Owner/DDS
Phone
(509) 299-5171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 4735 WA Primary

Addresses

Primary practice location

N 123 Brower
Medical Lake, WA 99022

Mailing address

PO Box 10
Medical Lake, WA 99022-0010
Phone (509) 299-5171

Other identifiers 1

IdentifierTypeStateIssuer
5511704MedicaidWA

Other names 1

  • Medical Lake Dental Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1266969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266969600000",
    "number": "1497077986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "MEDICAL LAKE",
            "state": "WA",
            "postal_code": "990220010",
            "telephone_number": "509-299-5171",
            "fax_number": "509-299-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N 123 BROWER",
            "city": "MEDICAL LAKE",
            "state": "WA",
            "postal_code": "99022",
            "telephone_number": "509-299-5171",
            "fax_number": "509-299-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE C TOILLION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-24",
        "last_updated": "2010-02-24",
        "status": "A",
        "authorized_official_last_name": "TOILLION",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/DDS",
        "authorized_official_telephone_number": "509-299-5171",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "4735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5511704",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Lake Dental",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Medical Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; 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.