NPIMap

Organization Active NPI

Theron Manson DDS PS

  • Dentist
  • Kirkland, WA
National Provider Identifier
1962754762
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9434 Issued in WA
Legal business name
THERON MANSON DDS PS
Practice address
9750 NE 120TH PL #8
Kirkland, WA 98034-4207
Phone
(425) 823-1909
Fax
(425) 823-8969
NPI assigned
Oct 4, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Authorized official

Name
Theron Angus Manson, DDSNPI 1073683074
Title
Dentist/President
Phone
(425) 823-1909

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 9434 WA Primary

Addresses

Primary practice location

9750 NE 120TH PL #8
Kirkland, WA 98034-4207

Mailing address

9750 NE 120TH PL #8
Kirkland, WA 98034-4207
Phone (425) 823-1909

National Provider Directory

National Provider Directory

Locations

9750 NE 120th Pl
Ste 8
Kirkland, WA 98034
Phone (425) 823-1909

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": "1349308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349308800000",
    "number": "1962754762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9750 NE 120TH PL #8",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980344207",
            "telephone_number": "425-823-1909",
            "fax_number": "425-823-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9750 NE 120TH PL #8",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980344207",
            "telephone_number": "425-823-1909",
            "fax_number": "425-823-8969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERON MANSON DDS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-04",
        "last_updated": "2012-10-04",
        "status": "A",
        "authorized_official_last_name": "MANSON",
        "authorized_official_first_name": "THERON",
        "authorized_official_middle_name": "ANGUS",
        "authorized_official_title_or_position": "DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "425-823-1909",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "9434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.