Organization Active NPI

Renee Sheeler Denture Clinic, Inc

  • Denturist
  • Kelso, WA
National Provider Identifier
1699422386
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DenturistTaxonomy code 122400000X
Legal business name
RENEE SHEELER DENTURE CLINIC, INC
Practice address
205 Pacific Ave N
Kelso, WA 98626-3413
Phone
(360) 575-1667
NPI assigned
Mar 3, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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

Authorized official

Name
Mrs. Amy Martzall
Title
Office Manager
Phone
(360) 575-1667

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DenturistGroup: 193400000X SINGLE SPECIALTY GROUP 122400000X Primary

Addresses

Primary practice location

205 Pacific Ave N
Kelso, WA 98626-3413

Mailing address

205 Pacific Ave N
Kelso, WA 98626-3413
Phone (360) 575-1667

National Provider Directory

National Provider Directory

Locations

205 Pacific Ave N
Kelso, WA 98626
Phone (360) 575-1667

Practitioners & affiliated clinicians

Practitioners 2

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": "1646265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646265600000",
    "number": "1699422386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 PACIFIC AVE N",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "986263413",
            "telephone_number": "360-575-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 PACIFIC AVE N",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "986263413",
            "telephone_number": "360-575-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEE SHEELER DENTURE CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-03",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A",
        "authorized_official_last_name": "MARTZALL",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-575-1667",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Denturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kelso, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.