NPIMap

Organization Active NPI

Sedro-Woolley Family Dental Center

  • General Practice Dentistry
  • Sedro-Woolley, WA
National Provider Identifier
1902121155
Registry record updated Mar 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4339 Issued in WA
Legal business name
SEDRO-WOOLLEY FAMILY DENTAL CENTER
Doing business as
Glyn A. Fleury DDS
Practice address
830 Metcalf Street
Sedro-Woolley, WA 98284
Phone
(360) 855-0351
Fax
(360) 855-9357
NPI assigned
Mar 31, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2010

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

Authorized official

Name
Dr. Glyn A. Fleury, D.D.S. (DENTIST)NPI 1932266640
Title
Owner
Phone
(360) 855-0351

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
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 4339 WA Primary

Addresses

Primary practice location

830 Metcalf Street
Sedro-Woolley, WA 98284

Mailing address

830 Metcalf Street
Sedro-Woolley, WA 98284
Phone (360) 855-0351

Other names 1

  • Glyn A. Fleury DDS Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1269993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269993600000",
    "number": "1902121155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 METCALF STREET",
            "city": "SEDRO-WOOLLEY",
            "state": "WA",
            "postal_code": "98284",
            "telephone_number": "360-855-0351",
            "fax_number": "360-855-9357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 METCALF STREET",
            "city": "SEDRO-WOOLLEY",
            "state": "WA",
            "postal_code": "98284",
            "telephone_number": "360-855-0351",
            "fax_number": "360-855-9357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEDRO-WOOLLEY FAMILY DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-31",
        "last_updated": "2010-03-31",
        "status": "A",
        "authorized_official_last_name": "FLEURY",
        "authorized_official_first_name": "GLYN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-855-0351",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S. (DENTIST)"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "4339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glyn A. Fleury DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sedro-Woolley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2010; 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.