Active NPI
Gregory L Psaltis, DDS
- Pediatric Dentistry
- Olympia, WA
National Provider Identifier
1972682565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DE00004885
- Practice address
- 222 Lilly Rd NE
Olympia, WA 98506 - Phone
- (360) 459-5885
- Fax
- (360) 459-7115
- NPI assigned
- Nov 3, 2006
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DE00004885 | WA | Primary |
Addresses
Primary practice location
222 Lilly Rd NE
Olympia, WA 98506
Mailing address
222 Lilly Rd NE
Olympia, WA 98506
Phone (360) 459-5885
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5022207 | Medicaid | WA |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE00004885 | WA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rowley and Ruder, PLLC | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Small To Tall Pediatric Dentistry
- Pediatric Dentistry
- Olympia, WA
- NPI 1598979866
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972682565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 LILLY RD NE",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "98506",
"telephone_number": "360-459-5885",
"fax_number": "360-459-7115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 LILLY RD NE",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "98506",
"telephone_number": "360-459-5885",
"fax_number": "360-459-7115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PSALTIS",
"first_name": "GREGORY",
"middle_name": "L",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "WA",
"license": "DE00004885",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5022207",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
- Providence Health & Services Washington
- Providence Health & Services Washington
- Providence Health & Services Washington (Providence Mother Joseph Care Center)
- Providence St. Peter Hospital (Providence St. Peter Hospital PAC LAB)
- Kathleen C Pruitt, MSW, LMHC
- Psychiatric and Counseling Services of Olympia, PS
- Psychiatric Services of Olympia PLLC
- Public Hospital District No 1 of Mason County (Olympia Ankle and Foot)
- Puget Sound Care LLC (Puget Sound Care)
- Puget Sound Gastroenterology, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.