NPIMap

Organization Active NPI

Confederated Tribes & Bands of the Yakama Nation

  • Dental Clinic/Center
  • Toppenish, WA
National Provider Identifier
1790977965
Registry record updated Jul 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DS-091445-L Issued in PA
Legal business name
CONFEDERATED TRIBES & BANDS OF THE YAKAMA NATION
Practice address
401 Buster Rd
Toppenish, WA 98948-9792
Phone
(509) 865-2102
Fax
(509) 865-8995
NPI assigned
Aug 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2009

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

Authorized official

Name
Ellen M Swan
Title
Program Manager
Phone
(509) 865-5121

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental HygienistGroup: 193400000X SINGLE SPECIALTY GROUP 124Q00000X
Dental Clinic/Center 261QD0000X DS-091445-L PA Primary

Addresses

Primary practice location

401 Buster Rd
Toppenish, WA 98948-9792

Mailing address

80 Birdsong Lane
White Swan, WA 98952
Phone (509) 865-5121

Other identifiers 1

IdentifierTypeStateIssuer
5400171MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
Confederated Tribes and Bands of the Yakama Nation10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247097600000",
    "number": "1790977965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 BIRDSONG LANE",
            "city": "WHITE SWAN",
            "state": "WA",
            "postal_code": "98952",
            "telephone_number": "509-865-5121",
            "fax_number": "509-874-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BUSTER RD",
            "city": "TOPPENISH",
            "state": "WA",
            "postal_code": "989489792",
            "telephone_number": "509-865-2102",
            "fax_number": "509-865-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONFEDERATED TRIBES & BANDS OF THE YAKAMA NATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-13",
        "last_updated": "2009-07-09",
        "status": "A",
        "authorized_official_last_name": "SWAN",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "509-865-5121"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "PA",
            "license": "DS-091445-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5400171",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toppenish, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2009; 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.