Active NPI
John Gary Palmer, DDS
- Dentist
- Spokane, WA
National Provider Identifier
1972669828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE8932
- Practice address
- 9717 N Nevada
Spokane, WA 99218 - Phone
- (589) 467-3315
- Fax
- (509) 467-3369
- NPI assigned
- Dec 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 20923 | CA | |
| Dentist | 122300000X | DE8932 | WA | Primary |
| Dentist | 122300000X | D3608 | ID |
Addresses
Primary practice location
9717 N Nevada
Spokane, WA 99218
Mailing address
6950 NE Campus Way
Hillsboro, OR 97124-5611
Phone (503) 952-2164
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20923 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| D3608 | ID | MD | Dentist |
| DE8932 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433462400000",
"number": "1972669828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6950 NE CAMPUS WAY",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971245611",
"telephone_number": "503-952-2164",
"fax_number": "503-526-4418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9717 N NEVADA",
"city": "SPOKANE",
"state": "WA",
"postal_code": "99218",
"telephone_number": "589-467-3315",
"fax_number": "509-467-3369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALMER",
"first_name": "JOHN",
"middle_name": "GARY",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-28",
"last_updated": "2015-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "20923",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE8932",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "ID",
"license": "D3608",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.