NPIMap

Organization Active NPI

Maloof & Wicklund PLLC

Doing business as Winslow Dental Group

  • Dentist
  • Bainbridge Island, WA
National Provider Identifier
1871707976
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MALOOF & WICKLUND PLLC
Doing business as
Winslow Dental Group
Practice address
727 Ericksen Ave NE
Suite 1
Bainbridge Island, WA 98110
Phone
(206) 842-6624
Fax
(206) 980-5654
NPI assigned
May 9, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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. Lance F Wicklund, DMDNPI 1831267947
Title
Owner
Phone
(206) 842-6624

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

727 Ericksen Ave NE
Suite 1
Bainbridge Island, WA 98110

Mailing address

727 Ericksen Ave NE
Suite 1
Bainbridge Island, WA 98110
Phone (206) 842-6624

Other names 1

  • Winslow Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

727 Ericksen Ave NE
Ste 1
Bainbridge Island, WA 98110
Phone (206) 842-6624

Practitioners & affiliated clinicians

Practitioners 2

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": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871707976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 ERICKSEN AVE NE",
            "address_2": "SUITE 1",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "98110",
            "telephone_number": "206-842-6624",
            "fax_number": "206-980-5654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 ERICKSEN AVE NE",
            "address_2": "SUITE 1",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "98110",
            "telephone_number": "206-842-6624",
            "fax_number": "206-980-5654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALOOF & WICKLUND PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WICKLUND",
        "authorized_official_first_name": "LANCE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-842-6624",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Winslow Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bainbridge Island, 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.