Individual provider Active NPI

Pamela Butler, DMD

  • Pediatric Dentistry
  • Vancouver, WA
National Provider Identifier
1801831508
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D6941 Issued in OR
Practice address
3205 SE 192ND Ave
Suite#100
Vancouver, WA 98683
Phone
(360) 891-9283
Fax
(360) 891-8030
NPI assigned
Jun 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X D6941 OR Primary

Addresses

Primary practice location

3205 SE 192ND Ave
Suite#100
Vancouver, WA 98683

Mailing address

3205 SE 192ND Ave
Suite#100
Vancouver, WA 98683
Phone (360) 891-9283

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D6941ORMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Undertheseadentistryforchildren Pediatric Dentistry Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801831508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 SE 192ND AVE",
            "address_2": "SUITE#100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98683",
            "telephone_number": "360-891-9283",
            "fax_number": "360-891-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 SE 192ND AVE",
            "address_2": "SUITE#100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98683",
            "telephone_number": "360-891-9283",
            "fax_number": "360-891-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "PAMELA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OR",
            "license": "D6941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.