NPIMap

Organization Active NPI

R. Charlie Collins and Ute J. Collins

Doing business as Roosevelt Dental Center

  • Dentist
  • Anacortes, WA
National Provider Identifier
1710300595
Registry record updated Jan 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE00010086 Issued in WA
Legal business name
R. CHARLIE COLLINS AND UTE J. COLLINS
Doing business as
Roosevelt Dental Center
Practice address
1220 22ND St
Suite C
Anacortes, WA 98221-2582
Phone
(360) 293-5311
Fax
(360) 293-5114
NPI assigned
Jan 29, 2014
Last updated
Jan 29, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2014

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

Authorized official

Name
Dr. Ryan Charlie Collins, D.D.S.NPI 1326018169
Title
Co-Owner
Phone
(360) 293-5311

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE00010086 WA Primary

Addresses

Primary practice location

1220 22ND St
Suite C
Anacortes, WA 98221-2582

Mailing address

1220 22ND St
Suite C
Anacortes, WA 98221-2582
Phone (360) 293-5311

Other names 1

  • Roosevelt Dental Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
R Charlie and Ute J Collins DDS PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1220 22nd St
Ste C
Anacortes, WA 98221
Phone (360) 293-5311

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1390953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390953600000",
    "number": "1710300595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 22ND ST",
            "address_2": "SUITE C",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212582",
            "telephone_number": "360-293-5311",
            "fax_number": "360-293-5114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 22ND ST",
            "address_2": "SUITE C",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212582",
            "telephone_number": "360-293-5311",
            "fax_number": "360-293-5114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R. CHARLIE COLLINS AND UTE J. COLLINS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-29",
        "last_updated": "2014-01-29",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "CHARLIE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "360-293-5311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00010086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roosevelt Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anacortes, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; 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.