NPIMap

Organization Active NPI

Keith Phillips, DMD, MSD, PS, Inc

  • Dental Clinic/Center
  • Fife, WA
National Provider Identifier
1497091243
Registry record updated Dec 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DE00007693 Issued in WA
Legal business name
KEITH PHILLIPS, DMD, MSD, PS, INC
Practice address
5619 Valley Ave E
Fife, WA 98424-2060
Phone
(253) 922-5519
Fax
(253) 922-2719
NPI assigned
Dec 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2012

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

Authorized official

Name
Dr. Keith Martin Phillips, DMD, MSDNPI 1063638310
Title
Owner
Phone
(253) 922-5519

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DE00007693 WA Primary

Addresses

Primary practice location

5619 Valley Ave E
Fife, WA 98424-2060

Mailing address

5619 Valley Ave E
Fife, WA 98424-2060
Phone (253) 922-5519

National Provider Directory

National Provider Directory

Locations

5619 Valley Ave E
Tacoma, WA 98424
Phone (253) 922-5519

Practitioners & affiliated clinicians

Practitioners 1

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": "1356480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356480000000",
    "number": "1497091243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5619 VALLEY AVE E",
            "city": "FIFE",
            "state": "WA",
            "postal_code": "984242060",
            "telephone_number": "253-922-5519",
            "fax_number": "253-922-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5619 VALLEY AVE E",
            "city": "FIFE",
            "state": "WA",
            "postal_code": "984242060",
            "telephone_number": "253-922-5519",
            "fax_number": "253-922-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH PHILLIPS, DMD, MSD, PS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-26",
        "last_updated": "2012-12-26",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-922-5519",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MSD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "DE00007693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fife, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2012; 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.