1295233344 NPI number — R.C. DOWNING DDS PS

Table of content: (NPI 1295233344)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295233344 NPI number — R.C. DOWNING DDS PS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
R.C. DOWNING DDS PS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295233344
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/02/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 173
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOODSPORT
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98548-0173
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-877-5151
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
68 N LAKE CUSHMAN ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOODSPORT
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98548-9854
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-878-5151
Provider Business Practice Location Address Fax Number:
206-400-5997
Provider Enumeration Date:
01/24/2018

Additional Information

Authorized Official

Authorized Official Last Name:
DOWNING
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
C
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
360-259-1984

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  DE00009067 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: DE00009067 . This is a "DENTAL LICENSE NUMBER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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