NPIMap

Organization Active NPI

Manuel la Rosa DDS PS

Doing business as Sound Oral and Maxillofacial Surgery

  • Dental Clinic/Center
  • Tacoma, WA
National Provider Identifier
1861604415
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DE8413 Issued in WA
Legal business name
MANUEL LA ROSA DDS PS
Doing business as
Sound Oral and Maxillofacial Surgery
Practice address
1628 S Mildred St
Suite 210
Tacoma, WA 98465-1627
Phone
(253) 564-1000
Fax
(253) 564-0102
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Manuel J La Rosa-Craig, DDS
Title
President
Phone
(253) 564-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DE8413 WA Primary

Addresses

Primary practice location

1628 S Mildred St
Suite 210
Tacoma, WA 98465-1627

Mailing address

1628 S Mildred St
Suite 210
Tacoma, WA 98465-1627
Phone (253) 564-1000

Other names 1

  • Sound Oral and Maxillofacial Surgery Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861604415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 S MILDRED ST",
            "address_2": "SUITE 210",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984651627",
            "telephone_number": "253-564-1000",
            "fax_number": "253-564-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 S MILDRED ST",
            "address_2": "SUITE 210",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984651627",
            "telephone_number": "253-564-1000",
            "fax_number": "253-564-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANUEL LA ROSA DDS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LA ROSA-CRAIG",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-564-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "DE8413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sound Oral and Maxillofacial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.