Custom Dental Inc

Primary specialty

DenturistTaxonomy code 122400000X

License

DN00000326 Issued in WA

Legal business name

CUSTOM DENTAL INC

Practice address

1103 S 20TH Ave
Yakima, WA 98902-5210

Phone

(509) 457-8768

NPI assigned

Sep 12, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Robert A Ford, LDN

Title

President

Phone

(509) 457-8768

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1669667663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 S 20TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989025210",
            "telephone_number": "509-457-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 S 20TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989025210",
            "telephone_number": "509-457-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-457-8768",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LDN"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Denturist",
            "state": "WA",
            "license": "DN00000326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael D Cunningham, PHD
• Charity Curnutt
• Steven Todd Curtis, P.A.-C.
• Taylor S Curtis, PA
• Custody Transport Services LLC
• Custom Tecnhology Co., Inc.
• Cwrcs Inc
• Miranda Cypher, L.M.T.
• Karen Kae Cyr, M.ED., LMHC
• Caila Ann Dahl

• Denturist in Yakima, WA
• Providers in Yakima, WA by specialty
• Denturist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.