NPIMap

Organization Active NPI

Donald C. Bassham D.D.S. P.S.

  • General Practice Dentistry
  • Walla Walla, WA
National Provider Identifier
1922258961
Registry record updated Jan 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00008030 Issued in WA
Legal business name
DONALD C. BASSHAM D.D.S. P.S.
Practice address
614 E Alder St
Suite # 6
Walla Walla, WA 99362-2073
Phone
(509) 526-7012
Fax
(509) 526-7013
NPI assigned
Sep 26, 2008
Last updated
Jan 15, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2009

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

Authorized official

Name
Dr. Donald Charles Bassham, D.D.S.NPI 1386764553
Title
Director
Phone
(509) 526-7012

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE00008030 WA Primary

Addresses

Primary practice location

614 E Alder St
Suite # 6
Walla Walla, WA 99362-2073

Mailing address

614 E Alder St
Suite # 6
Walla Walla, WA 99362-2073
Phone (509) 526-7012

Other identifiers 2

IdentifierTypeStateIssuer
5027610MedicaidWA
5057898MedicaidWA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1222387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231977600000",
    "number": "1922258961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 E ALDER ST",
            "address_2": "SUITE # 6",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622073",
            "telephone_number": "509-526-7012",
            "fax_number": "509-526-7013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 E ALDER ST",
            "address_2": "SUITE # 6",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622073",
            "telephone_number": "509-526-7012",
            "fax_number": "509-526-7013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD C. BASSHAM D.D.S. P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-26",
        "last_updated": "2009-01-15",
        "status": "A",
        "authorized_official_last_name": "BASSHAM",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "509-526-7012",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00008030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5027610",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5057898",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2009; 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.