1598008880 NPI number — THOMPSON. FERGUSON. STEINHART. JAMES, PLLC

Table of content: (NPI 1598008880)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598008880 NPI number — THOMPSON. FERGUSON. STEINHART. JAMES, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THOMPSON. FERGUSON. STEINHART. JAMES, PLLC
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:
APPLE VALLEY DENTAL AND ORTHODONTICS
Provider Other Organization Name Type Code:
3
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:
1598008880
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/25/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4309 W NOB HILL BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YAKIMA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98908-3971
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-823-4480
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6525 BURDEN BOULEVARD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PASCO
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-823-4480
Provider Business Practice Location Address Fax Number:
509-823-4488
Provider Enumeration Date:
04/04/2013

Additional Information

Authorized Official

Authorized Official Last Name:
THOMPSON
Authorized Official First Name:
DEREK
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
509-823-4480

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  DE60102410 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 122300000X , with the licence number: DE60232759 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 122300000X , with the licence number: DE60166205 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 122300000X , with the licence number: DE00009229 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 122300000X , with the licence number: DE60293839 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 122300000X , with the licence number: DE60232173 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 122300000X , with the licence number: DE00010686 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 122300000X , with the licence number: DE60170604 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1223X0400X , with the licence number: DE00011197 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1091661 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2013650 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2017327 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2020875 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2003693 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2011723 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2005801 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2009912 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1054937 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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