NPIMap

Organization Active NPI

Willamette Dental Group

  • Exclusive Provider Organization
  • Yakima, WA
National Provider Identifier
1972919496
Registry record updated Jul 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
H6653 Issued in OR
Legal business name
WILLAMETTE DENTAL GROUP
Practice address
1200 Chesterly Dr
Yakima, WA 98902-7338
Phone
(509) 452-7825
NPI assigned
Jul 3, 2014
Last updated
Jul 3, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2014

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

Authorized official

Name
Eugene Skourtes, DMD
Title
Owner/Ceo
Phone
(855) 433-6825

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X H6653 OR Primary

Addresses

Primary practice location

1200 Chesterly Dr
Yakima, WA 98902-7338

Mailing address

6950 NE Campus Way
Hillsboro, OR 97124-5611

National Provider Directory

National Provider Directory
Tax ID family
Willamette Dental Group PC22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404345600000",
    "number": "1972919496",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CHESTERLY DR",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027338",
            "telephone_number": "509-452-7825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLAMETTE DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-03",
        "last_updated": "2014-07-03",
        "status": "A",
        "authorized_official_last_name": "SKOURTES",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "855-433-6825",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "OR",
            "license": "H6653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2014; 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.