Three Rivers Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

THREE RIVERS DENTAL LLC

Doing business as

Three Rivers Dental

Practice address

620 Triangle Shopping Ctr Ste 660
Longview, WA 98632-4690

Phone

(360) 803-8003

NPI assigned

Feb 7, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Jared DomanNPI 1700051760

Title

Owner

Phone

(360) 601-9454

Specialties & licenses 1

Addresses

Other names 1

• Three Rivers Dental Doing business as

Locations

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.

• Jared Doman, DMD

  • Dentist
  • Longview, WA
  • NPI 1700051760
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675728000000",
    "number": "1932805363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 NW 164TH ST",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "986429478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 TRIANGLE SHOPPING CTR STE 660",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324690",
            "telephone_number": "360-803-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-07",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A",
        "authorized_official_last_name": "DOMAN",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-601-9454",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Three Rivers Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deja Thompson, MSW, LICSWA
• James Harold Thompson, PTA
• Kasie Thompson
• Marlyce D Thompson, RN
• Mark R Thorson, MD
• Thrifty Payless Inc (Rite Aid Pharmacy 05288)
• Grady Tift, L.M.P
• Nancy Tilton, R.N.
• Rachael Tilton
• Timber and Tide Counseling

• Dental Clinic/Center in Longview, WA
• Providers in Longview, WA by specialty
• Dental Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; 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.