NPIMap

Organization Active NPI

Kristan K Overby DDS PS

Doing business as DuPont Dental

  • General Practice Dentistry
  • Dupont, WA
National Provider Identifier
1902973696
Registry record updated Jul 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4388 Issued in WA
Legal business name
KRISTAN K OVERBY DDS PS
Doing business as
DuPont Dental
Practice address
1100 Station Dr
Suite 221
Dupont, WA 98327-9777
Phone
(253) 912-4443
Fax
(253) 912-4426
NPI assigned
Nov 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2008

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

Authorized official

Name
Mrs. Suezann Lassen Scott
Title
Office Manager
Phone
(253) 912-4443

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 4388 WA Primary

Addresses

Primary practice location

1100 Station Dr
Suite 221
Dupont, WA 98327-9777

Mailing address

1100 Station Dr
Suite 221
Dupont, WA 98327-9777
Phone (253) 912-4443

Other names 1

  • DuPont Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217462400000",
    "number": "1902973696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 STATION DR",
            "address_2": "SUITE 221",
            "city": "DUPONT",
            "state": "WA",
            "postal_code": "983279777",
            "telephone_number": "253-912-4443",
            "fax_number": "253-912-4426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 STATION DR",
            "address_2": "SUITE 221",
            "city": "DUPONT",
            "state": "WA",
            "postal_code": "983279777",
            "telephone_number": "253-912-4443",
            "fax_number": "253-912-4426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTAN K OVERBY DDS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2008-07-31",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "SUEZANN",
        "authorized_official_middle_name": "LASSEN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "253-912-4443",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "4388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DuPont Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dupont, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.