NPIMap

Organization Active NPI

Federal Way Dental LLC

  • Dentist
  • Federal Way, WA
National Provider Identifier
1619308137
Registry record updated Dec 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60398437 Issued in WA
Legal business name
FEDERAL WAY DENTAL LLC
Doing business as
Comfort Dental
Practice address
31401 Pacific Hwy S
Federal Way, WA 98003-5403
Phone
(253) 839-1007
Fax
(253) 839-4035
NPI assigned
Dec 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2013

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

Authorized official

Name
Nandita Lilly
Title
Dentist
Phone
(253) 839-1007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DE60398437 WA Primary

Addresses

Primary practice location

31401 Pacific Hwy S
Federal Way, WA 98003-5403

Mailing address

31401 Pacific Hwy S
Federal Way, WA 98003-5403
Phone (253) 839-1007

Other names 1

  • Comfort Dental Doing business as

National Provider Directory

National Provider Directory

Locations

31401 Pacific Hwy S
Federal Way, WA 98003
Phone (253) 839-1007

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": "1386547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386547200000",
    "number": "1619308137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31401 PACIFIC HWY S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035403",
            "telephone_number": "253-839-1007",
            "fax_number": "253-839-4035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31401 PACIFIC HWY S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035403",
            "telephone_number": "253-839-1007",
            "fax_number": "253-839-4035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FEDERAL WAY DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-09",
        "last_updated": "2013-12-09",
        "status": "A",
        "authorized_official_last_name": "LILLY",
        "authorized_official_first_name": "NANDITA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "253-839-1007"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60398437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comfort Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.