OLYMPIC DENTAL CENTER LLC NPI 1780733204

NPI Information

NPI: 1780733204
Provider Name: OLYMPIC DENTAL CENTER, LLC
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
4408 PACIFIC AVE SE
LACEY, WA
ZIP 98503
Phone: (360) 438-8299
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OLYMPIC DENTAL CENTER, LLC is a dental clinic center in Lacey, WA. OLYMPIC DENTAL CENTER, LLC NPI is 1780733204. The provider is registered as an organization entity type.

The provider's business location address is:

4408 PACIFIC AVE SE
LACEY, WA
ZIP 98503-119
Phone: (360) 438-8299
Fax: (360) 438-1399

The provider's authorized official is John Anderson .
The authorized official title is Denturist and has the following contact phone number (360) 438-8299.

The enumeration date for this NPI number is 1/10/2007 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	261QD0000X	Clinic/Center	Dental			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	1412978	OTHER	WASHINGTON	UNITED CONCORDIA
2	5040258	MEDICAID	WASHINGTON

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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