NPIMap

Organization Active NPI

Gresham Family Dental, LLC

Doing business as Sleep Dentistry of Vancouver -East

  • General Practice Dentistry
  • Camas, WA
National Provider Identifier
1760214357
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GRESHAM FAMILY DENTAL, LLC
Doing business as
Sleep Dentistry of Vancouver -East
Practice address
1821 SE 192ND Ave Ste 200
Camas, WA 98607-6507
Phone
(360) 852-8515
NPI assigned
Aug 14, 2024
Last updated
Aug 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Authorized official

Name
Laverne A Blair
Title
Insurance Coordinator
Phone
(360) 892-7107

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

1821 SE 192ND Ave Ste 200
Camas, WA 98607-6507

Mailing address

1821 SE 192ND Ave Ste 200
Camas, WA 98607-6507
Phone (360) 852-8515

Other names 1

  • Sleep Dentistry of Vancouver -East Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sleep Dentistry of Portland4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1821 SE 192nd Ave
Ste 200
Camas, WA 98607
Phone (360) 852-8515

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723593600000",
    "number": "1760214357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 SE 192ND AVE STE 200",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986076507",
            "telephone_number": "360-852-8515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 SE 192ND AVE STE 200",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986076507",
            "telephone_number": "360-852-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRESHAM FAMILY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-14",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "LAVERNE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "360-892-7107"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sleep Dentistry of Vancouver -East",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Camas, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.