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TRI-STAR DENTURE CLINIC NPI 1407176993


NPI Information

NPI: 1407176993
Provider Name: TRI-STAR DENTURE CLINIC
Classification: Denturist - 122400000X
Entity Type: Organization
Address:
2802 COLUMBIA ST
VANCOUVER, WA
ZIP 98660
Phone: (360) 906-0015
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TRI-STAR DENTURE CLINIC is a denturist in Vancouver, WA. The provider is a denturist is a licensed professional that serves patients with removable dental prosthetic oral health needs. A licensed denturist is trained in removable dental prosthetics and the fabrication of such devices. TRI-STAR DENTURE CLINIC NPI is 1407176993. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2802 COLUMBIA ST
VANCOUVER, WA
ZIP 98660-220
Phone: (360) 906-0015
Fax: (360) 906-0023

The provider's authorized official is Lenard Gobin Deochand .
The authorized official title is Denturist and has the following contact phone number (360) 906-0015.

The enumeration date for this NPI number is 6/7/2010 and was last updated on 6/7/2010.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1122300000XDentistWA00008442WASHINGTONNo
2122400000XDenturistDN00000394WASHINGTONYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1278500MEDICAIDOREGON
25047667MEDICAIDWASHINGTON

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

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