Quil Ceda Family Dental

Primary specialty

DentistTaxonomy code 122300000X

License

10444 Issued in WA

Legal business name

QUIL CEDA FAMILY DENTAL

Practice address

8825 34TH Ave NE Ste M
Tulalip, WA 98271-8085

Phone

(360) 659-1149

Fax

(360) 716-3626

NPI assigned

Aug 6, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Ronald A. Sebastian, DDS

Title

Dentist

Phone

(360) 659-1149

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1281052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281052800000",
    "number": "1831404466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8825 34TH AVE NE STE M",
            "city": "TULALIP",
            "state": "WA",
            "postal_code": "982718085",
            "telephone_number": "360-659-1149",
            "fax_number": "360-716-3626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8825 34TH AVE NE STE M",
            "city": "TULALIP",
            "state": "WA",
            "postal_code": "982718085",
            "telephone_number": "360-659-1149",
            "fax_number": "360-716-3626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUIL CEDA FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-06",
        "last_updated": "2010-08-06",
        "status": "A",
        "authorized_official_last_name": "SEBASTIAN",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "360-659-1149",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "10444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77045",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara S Pattison, RD
• Jarod Paul, DPT
• Tessa Pavey
• Carter Richard Pribnow
• Renee Francean Priest
• Antonia Ramos, M.S.
• Jean Patricia Reid, MD
• Maxine L Reid, M.D.
• Hillary Dyan Russell, MA, RC
• Cesar Eleno Santibanez

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; 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.