Kevin Clive, DDS
Individual provider Active NPI General Practice Dentistry · East Wenatchee, WA
NPI 1891424875 · NPPES record last updated Jun 21, 2022
Key facts
- NPI
- 1891424875
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DE61292349 (WA)
- Practice address
- 703 Valley Mall Pkwy
East Wenatchee, WA 98802-4839 - Phone
- (509) 745-5805
- NPI assigned
- Jun 6, 2022
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE61292349 | WA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DE61292349 | WA | Yes |
Addresses
Primary practice location
703 Valley Mall Pkwy
East Wenatchee, WA 98802-4839
Mailing address
703 Valley Mall Pkwy
East Wenatchee, WA 98802-4839
Phone (509) 745-5805
Other providers in East Wenatchee, WA
- Central Washington Health Services Association
- Giovanni Cervantes
- Justine Ann Champion
- Chelan-Douglas Health District
- Michael C Civile
- Cydne Cochran
- Angel Collins
- Columbia Valley Community Health
- Columbia Valley Community Health
- Columbia Valley Community Health
All providers in East Wenatchee, WA · General Practice Dentistry in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.