Creekside Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6279 Issued in WA

Legal business name

CREEKSIDE DENTAL

Practice address

910 NE Tenney Rd Ste 117
Vancouver, WA 98685-2838

Phone

(360) 695-1515

Fax

(360) 694-8449

NPI assigned

Aug 16, 2016

Last updated

Aug 16, 2016By 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

Dr. David Lewis Hanson, DDSNPI 1720142920

Title

Dentist/Owner

Phone

(360) 695-1515

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David L Hanson, D.D.S.

  • General Practice Dentistry
  • Vancouver, WA
  • NPI 1720142920
  NPD (past) Authorized official
• Jennifer Ficco, RDH

  • Dental Hygienist
  • Vancouver, WA
  • NPI 1003291527
  NPD (past)

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471305600000",
    "number": "1568917888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 NE TENNEY RD STE 117",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986852838",
            "telephone_number": "360-695-1515",
            "fax_number": "360-694-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 NE TENNEY RD STE 117",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986852838",
            "telephone_number": "360-695-1515",
            "fax_number": "360-694-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-16",
        "last_updated": "2016-08-16",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "LEWIS",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "360-695-1515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "6279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee A Crawford, MA
• Samantha Marie Crawford
• Shahna Marie Creagan, CDP, LMHC
• Nicole Creamer
• William Jeffrey Creed, DMD
• Creekside Medical, PS
• Carolyn Joy Creighton-Hein, LICSW
• Caitlin Christina Crenshaw
• Yvonka Crenshaw, MD
• Lisa Crespin

• General Practice Dentistry in Vancouver, WA
• Providers in Vancouver, 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 16, 2016; 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.