Puget Park Dental

Primary specialty

DentistTaxonomy code 122300000X

License

60223508 Issued in WA

Legal business name

PUGET PARK DENTAL

Practice address

520 128TH St SW
A 12
Everett, WA 98204-9362

Phone

(425) 290-5926

Fax

(425) 347-5229

NPI assigned

Aug 4, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Shivani Shikka Kant, DDS

Title

Dentist

Phone

(425) 290-5926

Specialties & licenses 1

Addresses

Other names 1

• Smile Marysville Doing business as

Locations

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

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470268800000",
    "number": "1780138917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 128TH ST SW",
            "address_2": "A 12",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982049362",
            "telephone_number": "425-290-5926",
            "fax_number": "425-347-5229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 128TH ST SW",
            "address_2": "A 12",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982049362",
            "telephone_number": "425-290-5926",
            "fax_number": "425-347-5229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUGET PARK DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-04",
        "last_updated": "2016-08-04",
        "status": "A",
        "authorized_official_last_name": "KANT",
        "authorized_official_first_name": "SHIVANI",
        "authorized_official_middle_name": "SHIKKA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "425-290-5926",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "60223508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Marysville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley J Pruitt
• Jill N Pruss, MA, LMHCA
• John D Pryor, M.D.
• PSPD - Everett, PLLC
• Puget Orthopedic Rehabilitation PC
• Puget Sound Dental Professionals PLLC
• Puget Sound Kidney Centers
• Puget Sound Massage LLC
• Jasmin Pulido
• Angelica Marie Pulley

• Dentist in Everett, WA
• Providers in Everett, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2016; 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.