NPIMap

Organization Active NPI

Swinomish Upper Skagit Dental

  • General Practice Dentistry
  • La Conner, WA
National Provider Identifier
1922203405
Registry record updated Aug 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6498 Issued in NC
Legal business name
SWINOMISH UPPER SKAGIT DENTAL
Practice address
17395 Reservation Rd
La Conner, WA 98257-8802
Phone
(360) 466-3900
Fax
(360) 466-7301
NPI assigned
Jun 15, 2007
Last updated
Aug 20, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2007

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

Authorized official

Name
Raymond A Dailey, DDSNPI 1427130145
Title
Dentist
Phone
(360) 466-3900

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 Dentistry 1223G0001X 6498 NC Primary

Addresses

Primary practice location

17395 Reservation Rd
La Conner, WA 98257-8802

Mailing address

PO Box 332
La Conner, WA 98257-0332
Phone (360) 466-3900

Other identifiers 1

IdentifierTypeStateIssuer
5039490MedicaidWA

Other names 1

  • Swinomish Tribal Community Other name

National Provider Directory

National Provider Directory
Tax ID family
Swinomish Upper Skagit Dental10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Practitioners & affiliated clinicians

Practitioners 5

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": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187568000000",
    "number": "1922203405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 332",
            "city": "LA CONNER",
            "state": "WA",
            "postal_code": "982570332",
            "telephone_number": "360-466-3900",
            "fax_number": "360-466-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17395 RESERVATION RD",
            "city": "LA CONNER",
            "state": "WA",
            "postal_code": "982578802",
            "telephone_number": "360-466-3900",
            "fax_number": "360-466-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWINOMISH UPPER SKAGIT DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2007-08-20",
        "status": "A",
        "authorized_official_last_name": "DAILEY",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "360-466-3900",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5039490",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Swinomish Tribal Community",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in La Conner, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; 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.