STILLAGUAMISH TRIBE OF INDIANS NPI 1821162033

NPI Information

NPI: 1821162033
Provider Name: STILLAGUAMISH TRIBE OF INDIANS

Other Name: STILLAGUAMISH FAMILY DENTISTRY

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
430 N WEST AVE
SUITE 1
ARLINGTON, WA
ZIP 98223
Phone: (360) 403-8761
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STILLAGUAMISH TRIBE OF INDIANS is a dental clinic center in Arlington, WA. STILLAGUAMISH TRIBE OF INDIANS NPI is 1821162033. The provider is registered as an organization entity type.
The provider Other Name Is Stillaguamish Family Dentistry.

The provider's business location address is:

430 N WEST AVE
SUITE 1
ARLINGTON, WA
ZIP 98223-539
Phone: (360) 403-8761
Fax: (360) 474-9085

The provider's authorized official is Brenda Tatro .
The authorized official title is Office Manager and has the following contact phone number (360) 403-8761.

The enumeration date for this NPI number is 11/20/2006 and was last updated on 8/22/2020.

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			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	5049770	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: 5/5/2024

NPI Synchronization or Removal

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