NPIMap

Organization Active NPI

Stillaguamish Tribe of Indians

  • Dental Clinic/Center
  • Arlington, WA
National Provider Identifier
1699861427
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
STILLAGUAMISH TRIBE OF INDIANS
Practice address
430 N West Ave Ste 1
Arlington, WA 98223-1539
Phone
(360) 403-8761
Fax
(360) 474-9085
NPI assigned
Oct 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Thomas Ashley
Title
Director of Social & Health Service
Phone
(360) 653-1104

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

430 N West Ave Ste 1
Arlington, WA 98223-1539

Mailing address

430 N West Ave Ste 1
Arlington, WA 98223-1539
Phone (360) 403-8761

Other identifiers 1

IdentifierTypeStateIssuer
5400015MedicaidWA

Other names 1

  • Stillaguamish Family Dentistry Other name

National Provider Directory

National Provider Directory
Tax ID family
Stillaguamish Tribe of Indians11 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

430 N West Ave
Ste 1
Arlington, WA 98223
Phone (360) 403-8761

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699861427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 N WEST AVE STE 1",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982231539",
            "telephone_number": "360-403-8761",
            "fax_number": "360-474-9085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 N WEST AVE STE 1",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982231539",
            "telephone_number": "360-403-8761",
            "fax_number": "360-474-9085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILLAGUAMISH TRIBE OF INDIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ASHLEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "DIRECTOR OF SOCIAL & HEALTH SERVICE",
        "authorized_official_telephone_number": "360-653-1104",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5400015",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stillaguamish Family Dentistry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Arlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.