Individual provider Active NPI

David B Swan, DDS

  • Dentist
  • Vancouver, WA
National Provider Identifier
1699884601
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3409 Issued in WA
Practice address
718 NE 87TH Ave Ste 100
Vancouver, WA 98664-1970
Phone
(360) 256-2400
Fax
(360) 253-9123
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3409 WA Primary

Addresses

Primary practice location

718 NE 87TH Ave Ste 100
Vancouver, WA 98664-1970

Mailing address

718 NE 87TH Ave Ste 100
Vancouver, WA 98664-1970
Phone (360) 256-2400

Other identifiers 1

IdentifierTypeStateIssuer
5012422MedicaidWA

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

LicenseStateTypeSpecialty
3409WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Vancouver Dental Centre Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699884601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 NE 87TH AVE STE 100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641970",
            "telephone_number": "360-256-2400",
            "fax_number": "360-253-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 NE 87TH AVE STE 100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641970",
            "telephone_number": "360-256-2400",
            "fax_number": "360-253-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAN",
        "first_name": "DAVID",
        "middle_name": "B",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "3409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5012422",
            "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 Jul 8, 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.