NPIMap

Organization Active NPI

Steven S. Broughton D.D.S. Dental of University Place PLLC

  • Dentist
  • University Place, WA
National Provider Identifier
1962708651
Registry record updated Jan 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7977 Issued in WA
Legal business name
STEVEN S. BROUGHTON D.D.S. DENTAL OF UNIVERSITY PLACE PLLC
Doing business as
Light Dental Studios University Place
Practice address
6706 24TH St W
University Place, WA 98466-5460
Phone
(253) 565-1145
Fax
(253) 565-5228
NPI assigned
Jan 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2011

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

Authorized official

Name
Darcy M Kanar
Title
Office Manager
Phone
(253) 565-1145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 7977 WA Primary

Addresses

Primary practice location

6706 24TH St W
University Place, WA 98466-5460

Mailing address

6706 24TH St W
University Place, WA 98466-5460
Phone (253) 565-1145

Other names 1

  • Light Dental Studios University Place Doing business as

National Provider Directory

National Provider Directory

Locations

6706 24th St W
University Place, WA 98466
Phone (253) 565-1145

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": "1296172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296172800000",
    "number": "1962708651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6706 24TH ST W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984665460",
            "telephone_number": "253-565-1145",
            "fax_number": "253-565-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6706 24TH ST W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984665460",
            "telephone_number": "253-565-1145",
            "fax_number": "253-565-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN S. BROUGHTON D.D.S. DENTAL OF UNIVERSITY PLACE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-28",
        "last_updated": "2011-01-28",
        "status": "A",
        "authorized_official_last_name": "KANAR",
        "authorized_official_first_name": "DARCY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "253-565-1145"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "7977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Light Dental Studios University Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in University Place, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2011; 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.