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KALISPEL TRIBE OF INDIANS NPI 1083980080


NPI Information

NPI: 1083980080
Provider Name: KALISPEL TRIBE OF INDIANS

Doing Business As: CAMAS CENTER DENTAL CLINIC

Classification: Dentist - 122300000X
Entity Type: Organization

CLIA Number: 50D1075165

Address:
1821 LECLERC RD N STE 1
CUSICK, WA
ZIP 99119
Phone: (509) 447-7111
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KALISPEL TRIBE OF INDIANS is a dentist in Cusick, WA. The provider is a dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. KALISPEL TRIBE OF INDIANS NPI is 1083980080. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Camas Center Dental Clinic.

The provider's business location address is:

1821 LECLERC RD N STE 1
CUSICK, WA
ZIP 99119-015
Phone: (509) 447-7111
Fax: (509) 445-1152

The provider's authorized official is Tracy Lynn Birdtail .
The authorized official title is Am and has the following contact phone number (509) 447-7112.

The CLIA number assigned to this NPI record is 50D1075165 - other with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/24/2012 and was last updated on 9/13/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1122300000XDentistDE00009801WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15051537MEDICAIDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.