NPIMap

Organization Active NPI

G Douglas Beck DDS PS

Doing business as Wildwood Dental Group

  • General Practice Dentistry
  • Mill Creek, WA
National Provider Identifier
1750685327
Registry record updated Dec 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE 004901 Issued in WA
Legal business name
G DOUGLAS BECK DDS PS
Doing business as
Wildwood Dental Group
Practice address
1617 183Rd St SE Ste 1
Mill Creek, WA 98012-6812
Phone
(425) 368-0600
Fax
(425) 368-0690
NPI assigned
Dec 22, 2010
Last updated
Dec 22, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2010

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

Authorized official

Name
Dr. George Douglas Beck, DDS
Title
Manager
Phone
(425) 368-0611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE 004901 WA Primary

Addresses

Primary practice location

1617 183Rd St SE Ste 1
Mill Creek, WA 98012-6812

Mailing address

1617 183Rd St SE Ste 1
Mill Creek, WA 98012-6812
Phone (425) 368-0600

Other names 1

  • Wildwood Dental Group Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1292976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292976000000",
    "number": "1750685327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1617 183RD ST SE STE 1",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980126812",
            "telephone_number": "425-368-0600",
            "fax_number": "425-368-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 183RD ST SE STE 1",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980126812",
            "telephone_number": "425-368-0600",
            "fax_number": "425-368-0690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G DOUGLAS BECK DDS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-22",
        "last_updated": "2010-12-22",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "425-368-0611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE 004901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wildwood Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mill Creek, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2010; 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.