Active NPI
Stephen B Gillespie, DDS
- Dentist
- Vancouver, WA
National Provider Identifier
1679633184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5353
- Practice address
- 13200 SE McGillivray Blvd
Vancouver, WA 98683-7040 - Phone
- (360) 892-6132
- Fax
- (360) 892-0297
- NPI assigned
- Dec 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5353 | WA | Primary |
Addresses
Primary practice location
13200 SE McGillivray Blvd
Vancouver, WA 98683-7040
Mailing address
13200 SE McGillivray Blvd
Vancouver, WA 98683-7040
Phone (360) 892-6132
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5557301 | Other | WA | DSHS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5353 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284076800000",
"number": "1679633184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13200 SE MCGILLIVRAY BLVD",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986837040",
"telephone_number": "360-892-6132",
"fax_number": "360-892-0297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13200 SE MCGILLIVRAY BLVD",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986837040",
"telephone_number": "360-892-6132",
"fax_number": "360-892-0297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLESPIE",
"first_name": "STEPHEN",
"middle_name": "B",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-12",
"last_updated": "2010-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "5353",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DSHS",
"identifier": "5557301",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.