NPIMap

Organization Active NPI

Korsmo & Henry DDS PS

  • Dentist
  • Puyallup, WA
National Provider Identifier
1982154233
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE00011049 Issued in WA
Legal business name
KORSMO & HENRY DDS PS
Practice address
5620 112TH St E Ste 250
Puyallup, WA 98373-3218
Phone
(253) 770-0529
Fax
(253) 770-9638
NPI assigned
Oct 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Authorized official

Name
Darilyn Henry
Title
General Manager
Phone
(253) 770-0529

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DE00011049 WA Primary

Addresses

Primary practice location

5620 112TH St E Ste 250
Puyallup, WA 98373-3218

Mailing address

5620 112TH St E Ste 250
Puyallup, WA 98373-3218
Phone (253) 770-0529

Other names 1

  • Puyallup Family Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Korsmo Henry DDS PS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476144000000",
    "number": "1982154233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5620 112TH ST E STE 250",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733218",
            "telephone_number": "253-770-0529",
            "fax_number": "253-770-9638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 112TH ST E STE 250",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733218",
            "telephone_number": "253-770-0529",
            "fax_number": "253-770-9638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KORSMO & HENRY DDS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-11",
        "last_updated": "2016-10-11",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "DARILYN",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "253-770-0529"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00011049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Puyallup Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; 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.