Dale Donaldson Nelson, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00006928 Issued in WA

Practice address

910 NE Minnehaha St
Suite 12
Vancouver, WA 98665-8750

Phone

(360) 696-9461

Fax

(360) 699-7199

NPI assigned

Oct 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Salmon Creek Family Dental

  • Dental Clinic/Center
  • Vancouver, WA
  • NPI 1588117568
  NPD (past) Authorized official

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629150198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 NE MINNEHAHA ST",
            "address_2": "SUITE 12",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986658750",
            "telephone_number": "360-696-9461",
            "fax_number": "360-699-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 NE MINNEHAHA ST",
            "address_2": "SUITE 12",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986658750",
            "telephone_number": "360-696-9461",
            "fax_number": "360-699-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "DALE",
        "middle_name": "DONALDSON",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00006928",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "37884",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D6622",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madhan Nellaiyappan, M.D.
• Daryn Nelsen-Soza, LSWIAC
• Daniel Reid Nelsen, PHARM.D
• Akina Nelson
• Angela Nelson, LMP
• Dwight L Nelson, BC-HIS
• Howard A Nelson, MD
• Joshua Herbert Nelson, M.D.
• Lyle Wilfred Nelson, M.D.,D.M.D.
• Michael John Nelson, M.D.

• 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.