Tacoma Denture Clinic

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5397 Issued in WA

Legal business name

TACOMA DENTURE CLINIC

Practice address

3712 S Cedar St
Tacoma, WA 98409-5715

Phone

(253) 475-8570

Fax

(253) 475-8577

NPI assigned

Nov 14, 2008

Last updated

Nov 14, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

William J Carlson, DDSNPI 1790866770

Title

Owner

Phone

(253) 475-8570

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William J Carlson, DDS

  • General Practice Dentistry
  • Tacoma, WA
  • NPI 1790866770
  Authorized official Same address or phone

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

{
    "created_epoch": "1226620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226620800000",
    "number": "1841444981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3712 S CEDAR ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984095715",
            "telephone_number": "253-475-8570",
            "fax_number": "253-475-8577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3712 S CEDAR ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984095715",
            "telephone_number": "253-475-8570",
            "fax_number": "253-475-8577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TACOMA DENTURE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-14",
        "last_updated": "2008-11-14",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-475-8570",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "5397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5042791",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5781604",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5012976",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tacoma Chiropractic Group LLC
• Tacoma Chiropractic Health Connection (The Health Connection)
• Tacoma Community College
• Tacoma Community House
• Tacoma Dental and Implant Center PS
• Tacoma Detoxification Center
• Tacoma Diagnostic Imaging Center, LLC
• Tacoma Digestive Disease Center
• Tacoma East Asian Medicine LLC
• Tacoma East of Cascadia, LLC

• General Practice Dentistry in Tacoma, WA
• Providers in Tacoma, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2008; 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.