NPIMap

Organization Active NPI

Cloverdale Family Dentistry

  • General Practice Dentistry
  • Seattle, WA
National Provider Identifier
1831534155
Registry record updated Apr 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00008520 Issued in WA
Legal business name
CLOVERDALE FAMILY DENTISTRY
Practice address
1415 S Cloverdale St
Seattle, WA 98108-4826
Phone
(206) 762-2337
Fax
(206) 762-0344
NPI assigned
Apr 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2013

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

Authorized official

Name
Tina Fujii, D.D.S.NPI 1144436916
Title
Owner
Phone
(206) 762-2337

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DE00008520 WA Primary

Addresses

Primary practice location

1415 S Cloverdale St
Seattle, WA 98108-4826

Mailing address

1415 S Cloverdale St
Seattle, WA 98108-4826
Phone (206) 762-2337

National Provider Directory

National Provider Directory

Locations

1415 S Cloverdale St
Seattle, WA 98108
Phone (206) 762-2337

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": "1367280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367280000000",
    "number": "1831534155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 S CLOVERDALE ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981084826",
            "telephone_number": "206-762-2337",
            "fax_number": "206-762-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 S CLOVERDALE ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981084826",
            "telephone_number": "206-762-2337",
            "fax_number": "206-762-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOVERDALE FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-30",
        "last_updated": "2013-04-30",
        "status": "A",
        "authorized_official_last_name": "FUJII",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-762-2337",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00008520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.