NPIMap

Organization Active NPI

Thompson.Ferguson.Steinhart.James.Leavitt,PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Sunnyside, WA
National Provider Identifier
1942589908
Registry record updated Mar 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
11197 Issued in WA
Legal business name
THOMPSON.FERGUSON.STEINHART.JAMES.LEAVITT,PLLC
Practice address
3217 Picard PL
Sunnyside, WA 98944-8400
Phone
(509) 790-0722
Fax
(509) 837-2517
NPI assigned
Aug 9, 2011
Reactivated
Mar 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2012

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

Authorized official

Name
Derek Thompson, DMD
Title
Owner
Phone
(509) 823-4480

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X DE 60187365 WA
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 11197 WA Primary

Addresses

Primary practice location

3217 Picard PL
Sunnyside, WA 98944-8400

Mailing address

4309 W Nob Hill Blvd
Yakima, WA 98908-3971
Phone (509) 823-4480

Other identifiers 2

IdentifierTypeStateIssuer
1091661MedicaidWA
2010061MedicaidWA

Other names 1

  • Apple Valley Dental and Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Apple Valley Dental and Orthodontics6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331510400000",
    "number": "1942589908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4309 W NOB HILL BLVD",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083971",
            "telephone_number": "509-823-4480",
            "fax_number": "509-823-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3217 PICARD PL",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989448400",
            "telephone_number": "509-790-0722",
            "fax_number": "509-837-2517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMPSON.FERGUSON.STEINHART.JAMES.LEAVITT,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-09",
        "last_updated": "2012-03-12",
        "deactivation_date": "2011-09-23",
        "reactivation_date": "2012-03-12",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-823-4480",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "DE 60187365",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "11197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1091661",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2010061",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Apple Valley Dental and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sunnyside, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; 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.