CLARK COUNTY DENTAL & DENTURE CLINIC NPI 1962423129

NPI Information

  • NPI: 1962423129
  • Provider Name: CLARK COUNTY DENTAL & DENTURE CLINIC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 2701 NE 114TH AVE
    # K-6
    VANCOUVER, WA
    ZIP 98684
  • Phone: (360) 892-7107

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NPI Details

CLARK COUNTY DENTAL & DENTURE CLINIC is a general practice dentist in Vancouver, 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. CLARK COUNTY DENTAL & DENTURE CLINIC NPI is 1962423129. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2701 NE 114TH AVE
# K-6
VANCOUVER, WA
ZIP 98684-289
Phone: (360) 892-7107
Fax: (360) 891-8361

The provider's authorized official is Sally Irene Fettig .
The authorized official title is Business Manager and has the following contact phone number (360) 892-7107.

The enumeration date for this NPI number is 7/22/2006 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
11223G0001XDentistGeneral PracticeDE00008735WASHINGTONYes

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
15048616MEDICAIDWASHINGTON
25036074MEDICAIDWASHINGTON
35047576MEDICAIDWASHINGTON
45041082MEDICAIDWASHINGTON
55026356MEDICAIDWASHINGTON

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: 11/21/2025

NPI Synchronization or Removal

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