House, Lee, Mast, McDonald and Nelson, PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DE60203055 Issued in WA

Legal business name

HOUSE, LEE, MAST, MCDONALD AND NELSON, PC

Practice address

107 E Cherry St
Walla Walla, WA 99362-1912

Phone

(509) 525-7336

NPI assigned

Jun 15, 2016

Organization subpart

No

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

Authorized official

Name

Mellissa Renner

Title

Regional Operations Manager

Phone

(541) 667-4145

Specialties & licenses 1

Addresses

Other names 2

• Advanced Pediatric Dentistry of Walla Walla Doing business as
• Craik Pediatric Dentistry Doing business as

Locations

Practitioners 1

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

• Mackenzie Craik, DDS

  • Pediatric Dentistry
  • Augusta, GA
  • NPI 1558626929
  NPD (past)

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597795200000",
    "number": "1740630342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 E CHERRY ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993621912",
            "telephone_number": "509-525-7336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E CHERRY ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993621912",
            "telephone_number": "509-525-7336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSE, LEE, MAST, MCDONALD AND NELSON, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-15",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A",
        "authorized_official_last_name": "RENNER",
        "authorized_official_first_name": "MELLISSA",
        "authorized_official_title_or_position": "REGIONAL OPERATIONS MANAGER",
        "authorized_official_telephone_number": "541-667-4145"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE60203055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Pediatric Dentistry of Walla Walla",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Craik Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hope Street
• Elisa L Hope, L.M.H.C.
• Hopestone PLLC
• Horizon Hearing & Tinnitus LLC
• Christy House, RD
• Kathryn Elizabeth Howard
• Melanie Earline Howard, ARNP
• Samuel Dalton Hubler, PHARM.D., MSHCA
• John D. Hughes, PH.D.
• Margaret Hummel, PHARMD

• Pediatric Dentistry in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Pediatric Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.