Organization Active NPI

Dental Services of Washington, Inc

  • Denturist
  • Tacoma, WA
National Provider Identifier
1942355979
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DenturistTaxonomy code 122400000X
Legal business name
DENTAL SERVICES OF WASHINGTON, INC
Practice address
10518 S Tacoma Way Ste B
Tacoma, WA 98499-5400
Phone
(253) 584-8840
Fax
(253) 584-8511
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Bruce Laverne Kizar, DPD
Title
President
Phone
(253) 584-8840

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
DenturistGroup: 193200000X MULTI-SPECIALTY GROUP 122400000X Primary

Addresses

Primary practice location

10518 S Tacoma Way Ste B
Tacoma, WA 98499-5400

Mailing address

10518 S Tacoma Way Ste B
Tacoma, WA 98499-5400
Phone (253) 584-8840

Other identifiers 1

IdentifierTypeStateIssuer
5042619MedicaidWA

National Provider Directory

National Provider Directory

Locations

10518 South Tacoma Way
Ste B
Tacoma, WA 98499
Phone (253) 584-8840

Practitioners & affiliated clinicians

Practitioners 1

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": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1942355979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10518 S TACOMA WAY STE B",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984995400",
            "telephone_number": "253-584-8840",
            "fax_number": "253-584-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10518 S TACOMA WAY STE B",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984995400",
            "telephone_number": "253-584-8840",
            "fax_number": "253-584-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SERVICES OF WASHINGTON, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "KIZAR",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "LAVERNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-584-8840",
        "authorized_official_credential": "DPD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Denturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5042619",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.