NPIMap

Organization Active NPI

Calvin L. Despain, DDS, PLLC

  • General Practice Dentistry
  • Moses Lake, WA
National Provider Identifier
1962007682
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CALVIN L. DESPAIN, DDS, PLLC
Practice address
1336 E Hunter PL
Moses Lake, WA 98837-2449
Phone
(509) 766-7076
NPI assigned
Dec 1, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Authorized official

Name
Dr. Calvin L Despain, DDSNPI 1699398834
Title
Owner/Dentist
Phone
(208) 550-4430

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1336 E Hunter PL
Moses Lake, WA 98837-2449

Mailing address

4514 W Peninsula Dr
Moses Lake, WA 98837-3031

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1606780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606780800000",
    "number": "1962007682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4514 W PENINSULA DR",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988373031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 E HUNTER PL",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988372449",
            "telephone_number": "509-766-7076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALVIN L. DESPAIN, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-01",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A",
        "authorized_official_last_name": "DESPAIN",
        "authorized_official_first_name": "CALVIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "208-550-4430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moses Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.