NPIMap

Organization Active NPI

Inland Oral Surgery P.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Spokane, WA
National Provider Identifier
1982965976
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DE00007006 Issued in WA
Legal business name
INLAND ORAL SURGERY P.S.
Practice address
2204 E 29TH Ave
Suite 104
Spokane, WA 99203-3961
Phone
(509) 321-1404
Fax
(509) 321-0211
NPI assigned
Jun 6, 2012
Organization subpart
Yes
Parent organization
INLAND ORAL SURGERY P.S.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Authorized official

Name
Dr. W. Dale Crum, D.D.SNPI 1609870070
Title
Owner
Phone
(509) 953-4067

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
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X DE00007006 WA Primary

Addresses

Primary practice location

2204 E 29TH Ave
Suite 104
Spokane, WA 99203-3961

Mailing address

2204 E 29TH Ave
Suite 104
Spokane, WA 99203-3961
Phone (509) 321-1404

Other identifiers 1

IdentifierTypeStateIssuer
1609870070MedicaidWA

National Provider Directory

National Provider Directory
Part of
Inland Oral Surgery PS

Locations

2204 E 29th Ave
Ste 104
Spokane, WA 99203
Phone (509) 321-1404

Practitioners & affiliated clinicians

Practitioners 4

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": "1338940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338940800000",
    "number": "1982965976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 E 29TH AVE",
            "address_2": "SUITE 104",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992033961",
            "telephone_number": "509-321-1404",
            "fax_number": "509-321-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 E 29TH AVE",
            "address_2": "SUITE 104",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992033961",
            "telephone_number": "509-321-1404",
            "fax_number": "509-321-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLAND ORAL SURGERY P.S.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INLAND ORAL SURGERY P.S.",
        "enumeration_date": "2012-06-06",
        "last_updated": "2012-06-06",
        "status": "A",
        "authorized_official_last_name": "CRUM",
        "authorized_official_first_name": "W. DALE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-953-4067",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE00007006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609870070",
            "state": "WA"
        }
    ],
    "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 6, 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.