Spavinawdental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

7925 Issued in WA

Legal business name

SPAVINAWDENTAL

Practice address

2201 E Edison Rd Ste 2
1726 Gregory Ave. Box 314
Sunnyside, WA 98944-9214

Phone

(509) 837-3090

Fax

(509) 837-3414

NPI assigned

May 14, 2010

Last updated

May 14, 2010By 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

Mr. Gregory John Norell, DDSNPI 1861559866

Title

Dentist

Phone

(509) 837-3090

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Greg Norell DDS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Greg Norell, DDS

  • General Practice Dentistry
  • Sunnyside, WA
  • NPI 1073918835
  NPD tax ID

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.

• Gregory John Norell, DDS

  • General Practice Dentistry
  • Sunnyside, WA
  • NPI 1861559866
  Authorized official Same address or phone

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

{
    "created_epoch": "1273795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273795200000",
    "number": "1841518859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 E EDISON RD STE 2",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989449214",
            "telephone_number": "509-837-3090",
            "fax_number": "509-837-3414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 E EDISON RD STE 2",
            "address_2": "1726 GREGORY AVE. BOX 314",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989449214",
            "telephone_number": "509-837-3090",
            "fax_number": "509-837-3414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPAVINAWDENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-14",
        "last_updated": "2010-05-14",
        "status": "A",
        "authorized_official_last_name": "NORELL",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "509-837-3090",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "7925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5052469",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory Alan Simmerman, CCC AUDIOLOGIST
• Sleep Medical Center of Tri-Cities, LLC (Silent Sleep Centers)
• Carolyn Smith
• Dana Lyn Smith, MSW, MHP,LICSW, CMHS
• Matthew Thomas Smith, RPH
• Amy Patricia Sprague, LMP
• Marie Teresa Stanford, MD
• James E Stevens, DR MEDICAL DENTISTRY
• Kristian L Stewart, CDPT
• Carla Sue Stoops, COTA/L

• Dental Clinic/Center in Sunnyside, WA
• Providers in Sunnyside, WA by specialty
• Dental Clinic/Center in Washington

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