Bagley Dental

Organization Active NPI General Practice Dentistry · Pasco, WA

NPI 1902032899 · NPPES record last updated Jun 5, 2009

Key facts

NPI
1902032899
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
DE 3657 (WA)
Legal business name
BAGLEY DENTAL
Practice address
1028 W Nixon St
Pasco, WA 99301-5216
Phone
(509) 547-1632
Fax
(509) 547-6932
NPI assigned
Jun 5, 2009
Organization subpart
Yes
Parent organization (as reported)
BAGLEY DENTAL, PS

Authorized official

Name
Dr. James Kent Bagley, D.D.S.
Title
Dental Provider
Phone
(509) 547-1632

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Corporate family (same tax ID) 1

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Bagley Dental PS (2 organizations share this tax ID)
Part of
Bagley Dental PS

Locations

1028 W Nixon St
Pasco, WA 99301
Phone (509) 547-1632

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X DE 3657 WA Yes

Addresses

Primary practice location

1028 W Nixon St
Pasco, WA 99301-5216

Mailing address

1028 W Nixon St
Pasco, WA 99301-5216
Phone (509) 547-1632

Other identifiers

IdentifierTypeStateIssuer
5050414MedicaidWA

Other providers in Pasco, WA

All providers in Pasco, WA · General Practice Dentistry in Washington

Sources for this page

Verify at the official NPI Registry.