Everett Mall Way Dental Group

Primary specialty

DentistTaxonomy code 122300000X

License

D00007661 Issued in WA

Legal business name

EVERETT MALL WAY DENTAL GROUP

Practice address

20 SW Everett Mall Way
Suite 1
Everett, WA 98204-2700

Phone

(425) 353-6254

Fax

(425) 353-6271

NPI assigned

Mar 26, 2009

Organization subpart

No

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

Authorized official

Name

Thomas F Helbert, DDS

Title

Owner

Phone

(425) 353-6254

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1238025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238025600000",
    "number": "1699917302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 SW EVERETT MALL WAY",
            "address_2": "SUITE 1",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982042700",
            "telephone_number": "425-353-6254",
            "fax_number": "425-353-6271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 SW EVERETT MALL WAY",
            "address_2": "SUITE 1",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982042700",
            "telephone_number": "425-353-6254",
            "fax_number": "425-353-6271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERETT MALL WAY DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-26",
        "last_updated": "2009-03-26",
        "status": "A",
        "authorized_official_last_name": "HELBERT",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-353-6254",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "D00007661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5058326",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Everett Denture Center PLLC
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• Everett Manor, LLC
• Everett MRI & Diagnostic Center LLC
• Everett Optometry Clinic, PLLC
• Everett Physical Therapy and Sport Performance Center PLLC
• Everett Post Acute, LLC

• Dentist in Everett, WA
• Providers in Everett, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2009; 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.