Active NPI
Condon Dental Services PS Inc
- General Practice Dentistry
- Spokane, WA
National Provider Identifier
1760655716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- CONDON DENTAL SERVICES PS INC
- Practice address
- 5901 N Lidgerwood
Suite 233
Spokane, WA 99208 - Phone
- (509) 489-4763
- Fax
- (509) 489-4767
- NPI assigned
- Apr 10, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael P Condon, DDS
- Title
- Owner
- Phone
- (509) 926-5272
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | WA | Primary |
Addresses
Primary practice location
5901 N Lidgerwood
Suite 233
Spokane, WA 99208
Mailing address
5901 N Lidgerwood
Suite 233
Spokane, WA 99208
Phone (509) 489-4763
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5055512 | Medicaid | WA |
Other names 1
- Northwest Dental Services
National Provider Directory
National Provider Directory- Tax ID family
- Condon Dental Services
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- General Practice Dentistry
- Odessa, WA
- NPI 1871548925
Locations
5901 N Lidgerwood St
Ste 233
Spokane, WA 99208
Phone (509) 489-4763
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.
-
- General Practice Dentistry
- Odessa, WA
- NPI 1871548925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207785600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1216166400000",
"number": "1760655716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5901 N LIDGERWOOD",
"address_2": "SUITE 233",
"city": "SPOKANE",
"state": "WA",
"postal_code": "99208",
"telephone_number": "509-489-4763",
"fax_number": "509-489-4767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5901 N LIDGERWOOD",
"address_2": "SUITE 233",
"city": "SPOKANE",
"state": "WA",
"postal_code": "99208",
"telephone_number": "509-489-4763",
"fax_number": "509-489-4767"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CONDON DENTAL SERVICES PS INC",
"organizational_subpart": "NO",
"enumeration_date": "2008-04-10",
"last_updated": "2008-07-16",
"status": "A",
"authorized_official_last_name": "CONDON",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "509-926-5272",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "WA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5055512",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Northwest Dental Services",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.