NPIMap

Organization Active NPI

Mountain View Dental

  • General Practice Dentistry
  • Ridgefield, WA
National Provider Identifier
1649713496
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE7985 Issued in WA
Legal business name
MOUNTAIN VIEW DENTAL
Practice address
2 S 56TH PL
Suite 202
Ridgefield, WA 98642-3425
Phone
(360) 887-1177
Fax
(360) 887-1178
NPI assigned
Nov 28, 2016
Last updated
Nov 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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

Authorized official

Name
Benjamin Crusan, DDSNPI 1710101076
Title
Owner/Dentist
Phone
(360) 887-1177

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE7985 WA Primary

Addresses

Primary practice location

2 S 56TH PL
Suite 202
Ridgefield, WA 98642-3425

Mailing address

2 S 56TH PL
Suite 202
Ridgefield, WA 98642-3425
Phone (360) 887-1177

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1480291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480291200000",
    "number": "1649713496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 S 56TH PL",
            "address_2": "SUITE 202",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "986423425",
            "telephone_number": "360-887-1177",
            "fax_number": "360-887-1178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 S 56TH PL",
            "address_2": "SUITE 202",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "986423425",
            "telephone_number": "360-887-1177",
            "fax_number": "360-887-1178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VIEW DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-28",
        "last_updated": "2016-11-28",
        "status": "A",
        "authorized_official_last_name": "CRUSAN",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "360-887-1177",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE7985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgefield, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.