NPIMap

Organization Active NPI

Mark D Teigen DDS PS

  • General Practice Dentistry
  • Longview, WA
National Provider Identifier
1740560911
Registry record updated Aug 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE7669 Issued in WA
Legal business name
MARK D TEIGEN DDS PS
Practice address
1105 14TH Ave
Longview, WA 98632-3016
Phone
(360) 425-8140
Fax
(360) 425-8145
NPI assigned
Aug 19, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2011

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

Authorized official

Name
Dr. Mark Douglas Teigen, DDSNPI 1851504757
Title
Owner
Phone
(360) 425-8140

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DE7669 WA Primary

Addresses

Primary practice location

1105 14TH Ave
Longview, WA 98632-3016

Mailing address

1105 14TH Ave
Longview, WA 98632-3016
Phone (360) 425-8140

Other names 1

  • Cascade Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

1105 14th Ave
Longview, WA 98632
Phone (360) 425-8140

Practitioners & affiliated clinicians

Practitioners 3

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": "1313712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313712000000",
    "number": "1740560911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 14TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323016",
            "telephone_number": "360-425-8140",
            "fax_number": "360-425-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 14TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323016",
            "telephone_number": "360-425-8140",
            "fax_number": "360-425-8145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK D TEIGEN DDS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-19",
        "last_updated": "2011-08-19",
        "status": "A",
        "authorized_official_last_name": "TEIGEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-425-8140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE7669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cascade Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Longview, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2011; 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.