Individual provider Active NPI

Carol Aicha O'Brien, D.D.S.

  • General Practice Dentistry
  • University Place, WA
National Provider Identifier
1659496065
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00008789 Issued in WA
Practice address
3702 Bridgeport Way W Ste a
University Place, WA 98466-4438
Phone
(253) 582-2408
Fax
(253) 584-7024
NPI assigned
Mar 21, 2007
Last updated
Jun 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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 DE00008789 WA Primary

Addresses

Primary practice location

3702 Bridgeport Way W Ste a
University Place, WA 98466-4438

Mailing address

3702 Bridgeport Way W Ste a
University Place, WA 98466-4438
Phone (253) 582-2408

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
DE00008789WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Family Dentistry Current Accepting new patients

Locations

703 Lilly Rd NE
Ste 201
Olympia, WA 98506
Phone (360) 459-3400

3702 Bridgeport Way W
Ste A
University Place, WA 98466
Phone (253) 582-2408

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1659496065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 BRIDGEPORT WAY W STE A",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664438",
            "telephone_number": "253-582-2408",
            "fax_number": "253-584-7024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 BRIDGEPORT WAY W STE A",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664438",
            "telephone_number": "253-582-2408",
            "fax_number": "253-584-7024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "CAROL",
        "middle_name": "AICHA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00008789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Place, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; 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.