Evergreen Dental

Primary specialty

DentistTaxonomy code 122300000X

License

DE60041682 Issued in WA

Legal business name

EVERGREEN DENTAL

Practice address

2403 E Evergreen Blvd
Vancouver, WA 98661-4320

Phone

(360) 696-1671

NPI assigned

May 13, 2013

Last updated

May 13, 2013By 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. Chad G Wade, DDS

Title

Dentist

Phone

(360) 921-2396

Specialties & licenses 1

Addresses

Locations

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.

• Michael Marion Scheel, DDS,PS

  • General Practice Dentistry
  • Vancouver, WA
  • NPI 1235282542
  NPD (past)

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

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368403200000",
    "number": "1700222197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2403 E EVERGREEN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986614320",
            "telephone_number": "360-696-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 E EVERGREEN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986614320",
            "telephone_number": "360-696-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-13",
        "last_updated": "2013-05-13",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "360-921-2396",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60041682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron H Even, M.D.
• Kimberley Ann Everett, NURSE PRACTITIONER
• Evergreen Audiology Gaming
• Evergreen Behavioral Health PC (Evergreen Behavioral Health)
• Evergreen Counseling Services, PC
• Evergreen Dental
• Evergreen Denture Center
• Evergreen Eye Care, LLC
• Evergreen Foot & Ankle Specialists PLLC
• Evergreen Medical Transportation LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2013; 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.