ELEVEN ELEVEN DENTAL NPI 1073763041

NPI Information

  • NPI: 1073763041
  • Provider Name: ELEVEN ELEVEN DENTAL
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 1111 COLUMBIA ST
    PORT ANGELES, WA
    ZIP 98362
  • Phone: (360) 457-3183

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NPI Details

ELEVEN ELEVEN DENTAL is a dental clinic center in Port Angeles, WA. ELEVEN ELEVEN DENTAL NPI is 1073763041. The provider is registered as an organization entity type.

The provider's business location address is:

1111 COLUMBIA ST
PORT ANGELES, WA
ZIP 98362-207
Phone: (360) 457-3183

The provider's authorized official is Gregory L Birch .
The authorized official title is President/owner and has the following contact phone number (360) 457-3183.

The enumeration date for this NPI number is 9/25/2008 and was last updated on 9/25/2008.

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
1261QD0000XClinic/CenterDental602789281WASHINGTONYes

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: 3/30/2025

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