Individual provider Active NPI

JD Troy, D.D.S.

  • General Practice Dentistry
  • Longview, WA
National Provider Identifier
1649364647
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE 00008468 Issued in WA
Practice address
1516 Hudson St
Suite 101
Longview, WA 98632-3083
Phone
(360) 423-5240
Fax
(360) 501-5391
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE 00008468 WA Primary

Addresses

Primary practice location

1516 Hudson St
Suite 101
Longview, WA 98632-3083

Mailing address

1516 Hudson St
Suite 101
Longview, WA 98632-3083
Phone (360) 423-5240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DE 00008468WAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649364647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 HUDSON ST",
            "address_2": "SUITE 101",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323083",
            "telephone_number": "360-423-5240",
            "fax_number": "360-501-5391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 HUDSON ST",
            "address_2": "SUITE 101",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323083",
            "telephone_number": "360-423-5240",
            "fax_number": "360-501-5391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROY",
        "first_name": "JD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE 00008468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.