LITTLE SPROUTS KIDS DENTISTRY NPI 1205373891

NPI Information

NPI: 1205373891
Provider Name: LITTLE SPROUTS KIDS DENTISTRY
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
4111 BRIDGEPORT WAY W
SUITE D
UNIVERSITY PLACE, WA
ZIP 98466
Phone: (626) 241-2669
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LITTLE SPROUTS KIDS DENTISTRY is a dental clinic center in University Place, WA. LITTLE SPROUTS KIDS DENTISTRY NPI is 1205373891. The provider is registered as an organization entity type.

The provider's business location address is:

4111 BRIDGEPORT WAY W
SUITE D
UNIVERSITY PLACE, WA
ZIP 98466-327
Phone: (626) 241-2669

The provider's authorized official is Melisa Tirtaputra Susanto .
The authorized official title is D.d.s, M.s. and has the following contact phone number (626) 241-2669.

The enumeration date for this NPI number is 1/20/2017 and was last updated on 1/20/2017.

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	DE 60481607	WASHINGTON	Yes

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: 11/14/2023

NPI Synchronization or Removal

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