NPIMap

Organization Active NPI

House, Lee, Mast, McDonald and Nelson, PC

Doing business as A Kids Place Dentistry for Children

  • Pediatric Dentistry
  • Renton, WA
National Provider Identifier
1770826927
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
HOUSE, LEE, MAST, MCDONALD AND NELSON, PC
Doing business as
A Kids Place Dentistry for Children
Practice address
451 Duvall Ave NE
Suite 140
Renton, WA 98059-4675
Phone
(425) 228-5437
Fax
(425) 663-7990
NPI assigned
Apr 5, 2013
Last updated
Dec 30, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
HOUSE, LEE, MAST, MCDONALD AND NELSON, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Authorized official

Name
Lanette McIntosh
Title
Regional Operations Manager
Phone
(425) 396-1011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X NU Primary

Addresses

Primary practice location

451 Duvall Ave NE
Suite 140
Renton, WA 98059-4675

Mailing address

451 Duvall Ave NE
Suite 140
Renton, WA 98059-4675
Phone (425) 228-5437

Other identifiers 1

IdentifierTypeStateIssuer
5048921MedicaidWA

Other names 1

  • A Kids Place Dentistry for Children Doing business as

National Provider Directory

National Provider Directory
Tax ID family
A Kids Place Dentistry for Children2 organizations share this tax ID, including this one
Part of
House Lee Mast McDonald and Nelson PC

Other organizations with this tax ID 1

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

Locations

451 Duvall Ave NE
Ste 140
Renton, WA 98059
Phone (425) 228-5437

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1365120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609286400000",
    "number": "1770826927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 DUVALL AVE NE",
            "address_2": "SUITE 140",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980594675",
            "telephone_number": "425-228-5437",
            "fax_number": "425-663-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 DUVALL AVE NE",
            "address_2": "SUITE 140",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980594675",
            "telephone_number": "425-228-5437",
            "fax_number": "425-663-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSE, LEE, MAST, MCDONALD AND NELSON, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOUSE, LEE, MAST, MCDONALD AND NELSON, PC",
        "enumeration_date": "2013-04-05",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A",
        "authorized_official_last_name": "MCINTOSH",
        "authorized_official_first_name": "LANETTE",
        "authorized_official_title_or_position": "REGIONAL OPERATIONS MANAGER",
        "authorized_official_telephone_number": "425-396-1011"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5048921",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Kids Place Dentistry for Children",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "A Kids Place Dentistry for Children",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.