NPIMap

Organization Active NPI

Kent Nuttall DMD PS

  • General Practice Dentistry
  • Auburn, WA
National Provider Identifier
1942533351
Registry record updated Sep 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7439 Issued in WA
Legal business name
KENT NUTTALL DMD PS
Practice address
722 12TH St SE
Auburn, WA 98002-6708
Phone
(253) 939-0700
NPI assigned
Sep 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2009

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

Authorized official

Name
Janna Collecchi
Title
Office Manager
Phone
(253) 939-0700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 7439 WA Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 10882 WA

Addresses

Primary practice location

722 12TH St SE
Auburn, WA 98002-6708

Mailing address

722 12TH St SE
Auburn, WA 98002-6708
Phone (253) 939-0700

National Provider Directory

National Provider Directory

Locations

722 12th St SE
Auburn, WA 98002
Phone (253) 833-5137

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": "1253059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253059200000",
    "number": "1942533351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 12TH ST SE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980026708",
            "telephone_number": "253-939-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 12TH ST SE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980026708",
            "telephone_number": "253-939-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENT NUTTALL DMD PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-16",
        "last_updated": "2009-09-16",
        "status": "A",
        "authorized_official_last_name": "COLLECCHI",
        "authorized_official_first_name": "JANNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "253-939-0700"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "7439",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "10882",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.