Organization Active NPI

Denture Services Northwest Inc

  • Denturist
  • Lakewood, WA
National Provider Identifier
1790247088
Registry record updated Oct 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DenturistTaxonomy code 122400000X
Legal business name
DENTURE SERVICES NORTHWEST INC
Practice address
6323 111TH St SW
Lakewood, WA 98499-1303
Phone
(253) 565-4435
Fax
(253) 565-4661
NPI assigned
Apr 4, 2019
Last updated
Oct 2, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2019

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

Authorized official

Name
Kim Foster
Title
Business Manager
Phone
(253) 565-4435

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Denturist 122400000X NU Primary

Addresses

Primary practice location

6323 111TH St SW
Lakewood, WA 98499-1303

Mailing address

6323 111TH St SW
Lakewood, WA 98499-1303
Phone (253) 565-4435

Other identifiers 1

IdentifierTypeStateIssuer
5038252MedicaidWA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569974400000",
    "number": "1790247088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6323 111TH ST SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984991303",
            "telephone_number": "253-565-4435",
            "fax_number": "253-565-4661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6323 111TH ST SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984991303",
            "telephone_number": "253-565-4435",
            "fax_number": "253-565-4661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTURE SERVICES NORTHWEST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-04",
        "last_updated": "2019-10-02",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "253-565-4435"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "",
            "desc": "Denturist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5038252",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; 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.