Pediatric Dental Care Center in Tacoma - Pediatric Dentistry
Pediatric Dental Care Center - NPI 1790947778
Pediatric Dental Care Center is a Pediatric Dentistry in Tacoma, Washington. Pediatric Dental Care Center practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Pediatric Dental Care Center is 1790947778. The last update date is 2008-06-30.
Pediatric Dental Care Center's current location address is 316 Martin Luther King Jr Way Ste 209, Tacoma, Washington. You can contact this provider via phone number 2536276023 and fax number 2536274035. The mailing address for Pediatric Dental Care Center is 316 Martin Luther King Jr Way Ste 209, Tacoma, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Pediatric Dental Care Center |
|---|---|
| Address | 316 Martin Luther King Jr Way Ste 209, Tacoma, Washington |
| Phone Number | 2536276023 |
| Fax Number | 2536274035 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DOCTOR |
|---|---|
| Authorized Official Name | Gibbons L. John |
| Credentials | D.M.D. |
| Telephone Number | 2536276023 |
NPI Number Detail
| NPI Number | 1790947778 |
|---|---|
| Provider Enumeration Date | 2008-06-30 |
| Last Updated Date | 2008-06-30 |
Provider Mailing Address Detail
| Address | 316 Martin Luther King Jr Way Ste 209 |
|---|---|
| City | Tacoma |
| State | Washington (WA) |
| Post Code | 984054254 |
| Phone Number | 2536276023 |
| Fax Number | 2536274035 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | DE05994 |
|
Definition: 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. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5000823 | WA | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Pediatric Dental Care Center by the Centers for Medicare & Medicaid Services?
The Pediatric Dental Care Center has been issued the NPI (National Provider Identifier) 1790947778. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Pediatric Dental Care Center's physical address?
The Pediatric Dental Care Center is physically located at 316 Martin Luther King Jr Way Ste 209, in the city of Tacoma, WA, with the postal code 984054254.
What is Pediatric Dental Care Center's specialized field of practice, and what is the corresponding taxonomy classification code?
The Pediatric Dental Care Center's area of specialization is Pediatric Dentistry, and the corresponding taxonomy code that categorizes this field of practice is 1223P0221X.
On what date did the Centers for Medicare & Medicaid Services issue the 1790947778 to Pediatric Dental Care Center?
The Pediatric Dental Care Center received its 1790947778 assignment from the Centers for Medicare & Medicaid Services on 2008-06-30.
As of what date was the information regarding Pediatric Dental Care Center, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Pediatric Dental Care Center, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2008-06-30.
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