Provider Type Icon

BONNEY LAKE DENTAL CENTER NPI 1477783199


NPI Information

NPI: 1477783199
Provider Name: BONNEY LAKE DENTAL CENTER
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 50D2282128

Address:
9925 214TH AVE E STE A
BONNEY LAKE, WA
ZIP 98391
Phone: (253) 863-4594
Get Directions

BONNEY LAKE DENTAL CENTER is a general practice dentist in Bonney Lake, WA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. BONNEY LAKE DENTAL CENTER NPI is 1477783199. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9925 214TH AVE E STE A
BONNEY LAKE, WA
ZIP 98391-910
Phone: (253) 863-4594
Fax: (253) 863-5061

The provider's authorized official is Delia Constantin .
The authorized official title is Dentist and has the following contact phone number (253) 863-4594.

The CLIA number assigned to this NPI record is 50D2282128 - other - afh with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/15/2009 and was last updated on 7/15/2009.


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
11223G0001XDentistGeneral PracticeYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.