Organization Active NPI

Newport Dental

  • Dental Clinic/Center
  • Newport, WA
National Provider Identifier
1720535297
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
5239 Issued in WA
Legal business name
NEWPORT DENTAL
Practice address
610 West Second St.
Box 849
Newport, WA 99156
Phone
(509) 447-3105
Fax
(509) 447-5661
NPI assigned
Sep 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2016

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

Authorized official

Name
James Gary Cool, DMDNPI 1376625442
Title
Dentist
Phone
(509) 447-3105

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
Dental Clinic/Center 261QD0000X 5239 WA Primary

Addresses

Primary practice location

610 West Second St.
Box 849
Newport, WA 99156

Mailing address

610 West Second St
Newport, WA 99156
Phone (509) 447-3105

Other identifiers 1

IdentifierTypeStateIssuer
1376625442MedicaidWA

National Provider Directory

National Provider Directory

Locations

610 W 2nd St
#849
Newport, WA 99156
Phone (509) 447-3105

610 W 2nd St
Newport, WA 99156
Phone (509) 447-3105

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472688000000",
    "number": "1720535297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 WEST SECOND ST",
            "city": "NEWPORT",
            "state": "WA",
            "postal_code": "99156",
            "telephone_number": "509-447-3105",
            "fax_number": "509-447-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 WEST SECOND ST.",
            "address_2": "BOX 849",
            "city": "NEWPORT",
            "state": "WA",
            "postal_code": "99156",
            "telephone_number": "509-447-3105",
            "fax_number": "509-447-5661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWPORT DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A",
        "authorized_official_last_name": "COOL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "509-447-3105",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "5239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376625442",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.