Southside Dental Care, Inc. P.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7450 Issued in WA

Legal business name

SOUTHSIDE DENTAL CARE, INC. P.S.

Practice address

1215 Old Fairhaven Pkwy
Suite #a
Bellingham, WA 98225-7444

Phone

(360) 752-9000

Fax

(360) 752-9846

NPI assigned

Mar 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Donald Thomas Walters, DDSNPI 1134266075

Title

President

Phone

(360) 752-9000

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Donald Thomas Walters, DDS

  • General Practice Dentistry
  • Bellingham, WA
  • NPI 1134266075
  NPD (past) Authorized official

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609995927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 OLD FAIRHAVEN PKWY",
            "address_2": "SUITE #A",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982257444",
            "telephone_number": "360-752-9000",
            "fax_number": "360-752-9846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 OLD FAIRHAVEN PKWY",
            "address_2": "SUITE #A",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982257444",
            "telephone_number": "360-752-9000",
            "fax_number": "360-752-9846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE DENTAL CARE, INC. P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-752-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "7450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• South Whatcom Fire Authority
• South Whatcom Fire Authority
• Southside Chiropractic Inc.
• Shaun Sowell, PHD, LMHCA
• Nina Ida Marie Spadaro, ED.D.
• Alicia Louise Spangenberger
• Angela Spangler
• Lyn Barber Spangler, LMT

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