NPIMap

Organization Active NPI

Family Group Dental Inc

  • Dental Clinic/Center
  • Everett, WA
National Provider Identifier
1508201732
Registry record updated May 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DE00008641 Issued in WA
Legal business name
FAMILY GROUP DENTAL INC
Practice address
909 SE Everett Mall Way
B-250
Everett, WA 98208
Phone
(425) 355-0600
NPI assigned
May 1, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2013

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

Authorized official

Name
Dr. Yuriy BagdasarovNPI 1609935857
Title
Owner
Phone
(425) 355-0600

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 DE00008641 WA Primary

Addresses

Primary practice location

909 SE Everett Mall Way
B-250
Everett, WA 98208

Mailing address

909 SE Everett Mall Way
B-250
Everett, WA 98208
Phone (425) 355-0600

National Provider Directory

National Provider Directory

Locations

909 SE Everett Mall Way
Ste B250
Everett, WA 98208
Phone (425) 355-0600

Practitioners & affiliated clinicians

Practitioners 2

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": "1367366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367366400000",
    "number": "1508201732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 SE EVERETT MALL WAY",
            "address_2": "B-250",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98208",
            "telephone_number": "425-355-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 SE EVERETT MALL WAY",
            "address_2": "B-250",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98208",
            "telephone_number": "425-355-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY GROUP DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-01",
        "last_updated": "2013-05-01",
        "status": "A",
        "authorized_official_last_name": "BAGDASAROV",
        "authorized_official_first_name": "YURIY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-355-0600",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "DE00008641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2013; 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.