LARRY HEGGERNESS SOCIAL PURPOSE PROFESSIONAL CORPORATION NPI 1124365796

NPI Information

NPI: 1124365796
Provider Name: LARRY HEGGERNESS SOCIAL PURPOSE PROFESSIONAL CORPORATION
Classification: Dentist - 1223P0221X
Entity Type: Organization

Specialization: Pediatric Dentistry

Address:
6720 FORT DENT WAY STE 120
TUKWILA, WA
ZIP 98188
Phone: (206) 242-4121
Get Directions

LARRY HEGGERNESS SOCIAL PURPOSE PROFESSIONAL CORPORATION is a pediatric dentistry dentist in Tukwila, WA. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. LARRY HEGGERNESS SOCIAL PURPOSE PROFESSIONAL CORPORATION NPI is 1124365796. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6720 FORT DENT WAY STE 120
TUKWILA, WA
ZIP 98188-580
Phone: (206) 242-4121
Fax: (206) 242-4113

The provider's authorized official is Larry K Heggerness .
The authorized official title is President and has the following contact phone number (206) 242-4121.

The enumeration date for this NPI number is 1/15/2013 and was last updated on 1/15/2013.

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	1223P0221X	Dentist	Pediatric Dentistry	DE00003686	WASHINGTON	Yes

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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