James Andrew Bagley, DDS – General Practice Dentistry

Key facts

NPI: 1992835045
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Dentistry 1223G0001X
License: DE7684 (WA)
Practice address: 4904 Convention Dr.
Pasco, WA 99301
Phone: (509) 547-1631
Fax: (509) 547-3885
NPI assigned: Mar 7, 2007
Sex: Male
Sole proprietor: No

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 and National Provider Directory roles.

Bagley Dental, PS General Practice Dentistry · Pasco, WA · NPI 1750507182

NPD (past) GENERAL PRACTICE

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
DE7684	WA	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
Bagley Dental, PS	General Practice	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Dentistry	1223G0001X	DE7684	WA	Yes

Addresses

Primary practice location

4904 Convention Dr.
Pasco, WA 99301

Mailing address

4904 Convention Dr.
Pasco, WA 99301
Phone (509) 547-1631

Other identifiers

Identifier	Type	State	Issuer
5050422	Medicaid	WA

Other providers in Pasco, WA

All providers in Pasco, WA · General Practice Dentistry in Washington

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.