NPIMap

Organization Active NPI

Phat Ly DMD PLLC

  • Dentist
  • Ridgefield, WA
National Provider Identifier
1841958626
Registry record updated Nov 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PHAT LY DMD PLLC
Practice address
8507 S 5TH St Ste 101
Ridgefield, WA 98642-3422
Phone
(360) 887-2310
NPI assigned
Nov 29, 2021
Last updated
Nov 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2021

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

Authorized official

Name
Dr. Phat Ly, DMDNPI 1720125966
Title
Dentist
Phone
(360) 213-6041

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

8507 S 5TH St Ste 101
Ridgefield, WA 98642-3422

Mailing address

8507 S 5TH St Ste 101
Ridgefield, WA 98642-3422
Phone (360) 887-2310

National Provider Directory

National Provider Directory

Locations

8507 S 5th St
Ste 101
Ridgefield, WA 98642
Phone (360) 887-2310

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638144000000",
    "number": "1841958626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8507 S 5TH ST STE 101",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "986423422",
            "telephone_number": "360-887-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8507 S 5TH ST STE 101",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "986423422",
            "telephone_number": "360-887-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHAT LY DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-29",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A",
        "authorized_official_last_name": "LY",
        "authorized_official_first_name": "PHAT",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "360-213-6041",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgefield, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.