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FEDERAL WAY DENTAL CLINIC NPI 1760936637


NPI Information

NPI: 1760936637
Provider Name: FEDERAL WAY DENTAL CLINIC
Classification: Preferred Provider Organization - 305R00000X
Entity Type: Organization

CLIA Number: 50D2250642

Address:
2016 S 320TH ST
SUITE F
FEDERAL WAY, WA
ZIP 98003
Phone: (253) 839-8106
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FEDERAL WAY DENTAL CLINIC is a preferred provider organization in Federal Way, WA. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. FEDERAL WAY DENTAL CLINIC NPI is 1760936637. The provider is registered as an organization entity type.

The provider's business location address is:

2016 S 320TH ST
SUITE F
FEDERAL WAY, WA
ZIP 98003-453
Phone: (253) 839-8106
Fax: (253) 941-7989

The provider's authorized official is Yong K Park .
The authorized official title is Owner and has the following contact phone number (253) 839-8106.

The CLIA number assigned to this NPI record is 50D2250642 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 8/9/2016 and was last updated on 8/9/2016.


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
1305R00000XPreferred Provider OrganizationDE00009186WASHINGTONYes

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

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