NPIMap

Organization Active NPI

Lacey Dental, LLC

  • Dentist
  • Lacey, WA
National Provider Identifier
1831520162
Registry record updated Dec 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE 60178653 Issued in WA
Legal business name
LACEY DENTAL, LLC
Practice address
1110 Galaxy Dr NE
Lacey, WA 98516-4763
Phone
(253) 537-1559
Fax
(253) 536-5907
NPI assigned
Dec 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2013

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

Authorized official

Name
Scott Probst, DDS
Title
Owner
Phone
(253) 537-1559

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DE 60178653 WA Primary

Addresses

Primary practice location

1110 Galaxy Dr NE
Lacey, WA 98516-4763

Mailing address

1110 Galaxy Dr NE
Lacey, WA 98516-4763
Phone (253) 537-1559

Other names 1

  • Comfort Dental Lacey Doing business as

National Provider Directory

National Provider Directory

Locations

1110 Galaxy Dr NE
Lacey, WA 98516
Phone (253) 537-1559

NPI Registry JSON

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

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386806400000",
    "number": "1831520162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 GALAXY DR NE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985164763",
            "telephone_number": "253-537-1559",
            "fax_number": "253-536-5907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 GALAXY DR NE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985164763",
            "telephone_number": "253-537-1559",
            "fax_number": "253-536-5907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LACEY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-12",
        "last_updated": "2013-12-12",
        "status": "A",
        "authorized_official_last_name": "PROBST",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-537-1559",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE 60178653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comfort Dental Lacey",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lacey, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; 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.