WILLIE M HARDIE DDS NPI 1093891533

NPI Information

NPI: 1093891533
Provider Name: WILLIE M HARDIE, DDS
Classification: Dentist - 1223P0221X
Entity Type: Individual

Specialization: Pediatric Dentistry

Address:
925 NE 136TH AVE
SUITE 101
VANCOUVER, WA
ZIP 98684
Phone: (360) 694-5559
Get Directions

Willie M Hardie, DDS is a pediatric dentistry dentist in Vancouver, 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. Willie M Hardie, DDS NPI is 1093891533. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

925 NE 136TH AVE
SUITE 101
VANCOUVER, WA
ZIP 98684-896
Phone: (360) 694-5559
Fax: (360) 891-0000

The enumeration date for this NPI number is 10/27/2006 and was last updated on 9/14/2010.

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	DE00008741	WASHINGTON	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	2007980	OTHER	WASHINGTON	GROUP MEDICAID
2	1002369	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: 4/28/2024

NPI Synchronization or Removal

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