NPIMap

Organization Active NPI

Pacific Dental & Denture Clinic,Inc

Doing business as Pacific Dental & Denture Clinic

  • Dental Clinic/Center
  • Federal Way, WA
National Provider Identifier
1619411568
Registry record updated Dec 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
PACIFIC DENTAL & DENTURE CLINIC,INC
Doing business as
Pacific Dental & Denture Clinic
Practice address
33505 Pacific Hwy S
Federal Way, WA 98003-6809
Phone
(253) 815-8850
Fax
(253) 815-8501
NPI assigned
Dec 12, 2016
Last updated
Dec 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2016

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

Authorized official

Name
Dusik Jung, DN00000137
Title
Owner/Denturist
Phone
(253) 815-8500

Specialties & licenses 1

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

Addresses

Primary practice location

33505 Pacific Hwy S
Federal Way, WA 98003-6809

Mailing address

33505 Pacific Hwy S
Federal Way, WA 98003-6809
Phone (253) 815-8850

Other names 1

  • PACIFIC DENTAL & DENTURE CLINIC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481500800000",
    "number": "1619411568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33505 PACIFIC HWY S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036809",
            "telephone_number": "253-815-8850",
            "fax_number": "253-815-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33505 PACIFIC HWY S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036809",
            "telephone_number": "253-815-8850",
            "fax_number": "253-815-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC DENTAL & DENTURE CLINIC,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-12",
        "last_updated": "2016-12-12",
        "status": "A",
        "authorized_official_last_name": "JUNG",
        "authorized_official_first_name": "DUSIK",
        "authorized_official_title_or_position": "OWNER/DENTURIST",
        "authorized_official_telephone_number": "253-815-8500",
        "authorized_official_credential": "DN00000137"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PACIFIC DENTAL & DENTURE CLINIC",
            "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 12, 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.