IVORY DENTURE CARE INC. NPI 1922164557

NPI Information

NPI: 1922164557
Provider Name: IVORY DENTURE CARE, INC.

Former Legal Business Name: DISANTIS PROSTHETICS

Classification: Denturist - 122400000X
Entity Type: Organization
Address:
210 S 11TH AVE
SUITE #45
YAKIMA, WA
ZIP 98902
Phone: (509) 454-2273
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IVORY DENTURE CARE, INC. is a denturist in Yakima, WA. The provider is a denturist is a licensed professional that serves patients with removable dental prosthetic oral health needs. A licensed denturist is trained in removable dental prosthetics and the fabrication of such devices. IVORY DENTURE CARE, INC. NPI is 1922164557. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Disantis Prosthetics.

The provider's business location address is:

210 S 11TH AVE
SUITE #45
YAKIMA, WA
ZIP 98902-293
Phone: (509) 454-2273
Fax: (509) 454-7901

The provider's authorized official is William S. Disantis .
The authorized official title is Owner and has the following contact phone number (509) 454-2273.

The enumeration date for this NPI number is 12/28/2006 and was last updated on 8/22/2020.

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
1	122400000X	Denturist		DN00000367	WASHINGTON	Yes

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
1	5048293	MEDICAID	WASHINGTON
2	DN00000367	OTHER	WASHINGTON	LICENSE #

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

NPI Synchronization or Removal

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