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Contact Information

DENTISTRY NORTHWEST
131 RANDOLPH ST
PORT HADLOCK-IRONDALE, WA98339
 Phone: 360-385-1000
 Fax: 360-385-0899
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for DENTISTRY NORTHWEST

NPI # 1083834675
LBN Legal business name DENTISTRY NORTHWEST
Authorized official JOHN BARRETT - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/26/2007
Last updated 08/22/2020 - About 6 years ago
Identifiers
WA License # 5050
WA Medicaid 5534904
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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