NPIMap

Organization Active NPI

PSPD - Everett, PLLC

  • Pediatric Dentistry
  • Everett, WA
National Provider Identifier
1659940468
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
PSPD - EVERETT, PLLC
Practice address
3224 Colby Ave Ste a
Everett, WA 98201-4383
Phone
(425) 259-3505
NPI assigned
Jun 24, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Authorized official

Name
Jessica Knight
Title
Credential Manager
Phone
(360) 659-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

3224 Colby Ave Ste a
Everett, WA 98201-4383

Mailing address

3224 Colby Ave Ste a
Everett, WA 98201-4383
Phone (425) 259-3505

National Provider Directory

National Provider Directory

Locations

3224 Colby Ave
Ste A
Everett, WA 98201
Phone (425) 259-3505

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624492800000",
    "number": "1659940468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3224 COLBY AVE STE A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014383",
            "telephone_number": "425-259-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3224 COLBY AVE STE A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014383",
            "telephone_number": "425-259-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSPD - EVERETT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-24",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIAL MANAGER",
        "authorized_official_telephone_number": "360-659-8100"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.