Active NPI
David K Packard, DMD
- General Practice Dentistry
- Yakima, WA
National Provider Identifier
1740377670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7692
- Practice address
- 1501 S 40TH Ave
Yakima, WA 98908-3963 - Phone
- (509) 577-8277
- Fax
- (509) 573-4858
- NPI assigned
- Oct 10, 2006
- Last updated
- Mar 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7692 | WA | Primary |
Addresses
Primary practice location
1501 S 40TH Ave
Yakima, WA 98908-3963
Mailing address
1501 S 40TH Ave
Yakima, WA 98908-3963
Phone (509) 577-8277
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 481926 | Other | WA | UNITED CONCORDIA |
| 92560941 | Other | WA | TPIN |
| 112287 | Other | WA | LABOR & INDUSTRIES |
| 7692 | Other | WA | STATE LICENSE |
| 8923148 | Other | WA | CRIME VICTIMS |
| 5023478 | Medicaid | WA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7692 | WA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Packard, Packard & Packard, PS | General Practice | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Creekside Dental
- General Practice Dentistry
- Yakima, WA
- NPI 1811085665
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1740377670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 S 40TH AVE",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989083963",
"telephone_number": "509-577-8277",
"fax_number": "509-573-4858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 S 40TH AVE",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989083963",
"telephone_number": "509-577-8277",
"fax_number": "509-573-4858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACKARD",
"first_name": "DAVID",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-10",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "7692",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "481926",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TPIN",
"identifier": "92560941",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "112287",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "7692",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRIME VICTIMS",
"identifier": "8923148",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5023478",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Yakima, WA
- Jorge Luis Pacheco Jr., CO 61015379
- Pacific Cataract and Laser Institute Inc PC
- Pacific Medical, Inc. (Pacific Medical Prosthetics & Orthotics)
- Pacific Vascular Incorporated
- Bennett C Packard, DMD
- Owen E Packard, DDS
- Packard, Packard & Packard, PS (Creekside Dental)
- Craig A Padavich, MD
- Bacilio H Padilla, LICSW
- Julia Anne Padilla, MA61651429
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.