Pacific Northwest Oral and Maxillofacial Surgery

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

DE00006475 Issued in WA

Legal business name

PACIFIC NORTHWEST ORAL AND MAXILLOFACIAL SURGERY

Practice address

2345 SW 320TH St
Federal Way, WA 98023-2568

Phone

(253) 838-2123

Fax

(253) 874-3624

NPI assigned

Jul 1, 2014

Last updated

Jul 1, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Carl Kenneth Johnson, DDSNPI 1952494676

Title

Owner

Phone

(425) 277-1844

Specialties & licenses 1

Addresses

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.

• Carl Kenneth Johnson, DDS

  • Oral and Maxillofacial Pathology Dentistry
  • Renton, WA
  • NPI 1952494676
  Authorized official Same address or phone

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

{
    "created_epoch": "1404172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404172800000",
    "number": "1689080467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 SW 320TH ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980232568",
            "telephone_number": "253-838-2123",
            "fax_number": "253-874-3624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 SW 320TH ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980232568",
            "telephone_number": "253-838-2123",
            "fax_number": "253-874-3624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC NORTHWEST ORAL AND MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-01",
        "last_updated": "2014-07-01",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-277-1844",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE00006475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Herman Oxborrow
• Holland Pace
• Laura Pacheco Arias, LMFTA
• Pacific Dental & Denture Clinic,Inc (Pacific Dental & Denture Clinic)
• Pacific Northwest Chiro PLLC
• Pacific Palisades Podiatry PLLC
• Pacific Vascular Incorporated
• Pacmed Clinics (Pacific Medical Centers)
• Erika Helene Paduano-Karch, MA, LMFT
• Maryann Paholio

• Oral and Maxillofacial Surgery Clinic/Center in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; 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.