JUSTIN WAYNE FILLMORE (NPI# 1053651893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053651893 |
| Entity Type | Individual |
| Full Name | JUSTIN WAYNE FILLMORE |
| Credential | DDS |
| Practice Address |
2205 W Lincoln Ave Yakima WA 98902-2437 |
| Mailing Address |
210 S 66th Ave # 2 Yakima WA 98908-1722 |
| Practice Telephone | 5095753399 |
| Mailing Telephone | 8014484283 |
| Enumeration Date | 2013-02-14 |
| Last Update Date | 2013-02-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
60299331 | WA | Dental Providers |
| Street Address |
2205 W LINCOLN AVE |
| City | YAKIMA |
| State | WA |
| Zip Code | 98902-2437 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801810924 | Eric Hohman | Physician Assistant | 2205 W Lincoln Ave, Yakima, WA 98902-2437 | 2006-07-26 |
| 1457985574 | Brett Parks | Student in an Organized Health Care Education/Training Program | 2205 W Lincoln Ave, Yakima, WA 98902-2437 | 2020-02-27 |
| 1811521362 | Rosa Elvira Briseno | Case Manager/Care Coordinator | 2205 W Lincoln Ave, Yakima, WA 98902-2437 | 2020-02-24 |
| 1518510858 | Cecia Dianely Acevedo | Dietitian, Registered | 2205 W Lincoln Ave, Yakima, WA 98902-2437 | 2019-07-16 |
| 1619536034 | Maria Brnjic | Nurse Practitioner | 2205 W Lincoln Ave, Yakima, WA 98902-2437 | 2019-06-10 |
| 1336606300 | Stephanie Campbell | Student in an Organized Health Care Education/Training Program | 2205 W Lincoln Ave, Yakima, WA 98902-2437 | 2019-02-26 |
| 1295292266 | Emily Jean Loy | Student in an Organized Health Care Education/Training Program | 2205 W Lincoln Ave, Yakima, WA 98902-2437 | 2019-02-26 |
| 1124597281 | Jaime Lynn Wells | Registered Nurse | 2205 W Lincoln Ave, Yakima, WA 98902-2437 | 2018-11-19 |
| 1659856904 | Noemi Zarate | Case Manager/Care Coordinator | 2205 W Lincoln Ave, Yakima, WA 98902-2437 | 2018-10-02 |
| 1962999060 | Laboratory Corporation of America | Clinical Medical Laboratory | 2205 W Lincoln Ave, Yakima, WA 98902-2437 | 2018-04-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922653203 | Laboratory Corporation of America | Clinical Medical Laboratory | 314 S 11th Ave Suite A, Yakima, WA 98902 | 2019-08-05 |
| 1669967865 | Rebecca Schrader | Speech-Language Pathologist | Children's Village 3801 Kern Road, Yakima, WA 98902 | 2018-06-29 |
| 1720572928 | Hyperbaric Centers of Washington | Preventive Medicine | 302 S. 12th Ave., Yakima, WA 98902 | 2018-06-20 |
| 1487155503 | Courtney Lombardi | Nurse Practitioner | 1515 W Yakima Ave, Yakima, WA 98902 | 2018-02-23 |
| 1003329665 | Maria-elena Mendoza | Case Manager/Care Coordinator | 918 E Mead Avenue, Yakima, WA 98902 | 2017-11-06 |
| 1679017610 | Claudia Zepeda | Massage Therapist | 3908 Creekside Loop Ste # 110, Yakima, WA 98902 | 2016-12-09 |
| 1093194425 | Silas Klaver | Podiatrist | 1607 Creekside Loop Ste 140, Yakima, WA 98902 | 2015-05-18 |
| 1821490905 | Jen Lynn Silver | Massage Therapist | 3512 Tieton Dr, Yakima, WA 98902 | 2014-09-20 |
| 1194131383 | Brenna Claire Hayes | Genetic Counselor, MS | 2903 W Walnut, Yakima, WA 98902 | 2014-07-08 |
| 1720400435 | Agnes Nadine Jeske | Speech-Language Pathologist | 621 S. 13th Ave., Mckinley Elementary School, Yakima, WA 98902 | 2014-01-15 |
| Find all providers in zip 98902 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841544061 | Neal H. Smith Dmd Pllc | Dentist | 1011 S 85th Ave, Yakima, WA 98908-9332 | 2012-11-09 |
| 1588110464 | Ashley S. Tercero, D.d.s., P.l.l.c. | Dentist | 3909 Creekside Loop, Suite #140, Yakima, WA 98902-4880 | 2016-08-30 |
| 1376938894 | Michael Rees | Dentist | 2205 W Lincoln Ave, Yakima, WA 98902-2437 | 2015-04-01 |
| 1508056193 | Ashley Stormo Tercero | Dentist | 2205 W Lincoln Ave, Yakima, WA 98902-2437 | 2007-07-30 |
| 1013107937 | Jessica R Webb | Dentist | 3801 Kern Way, Yakima, WA 98902-6340 | 2007-07-26 |
| 1972712966 | Geoffrey Tyler Ping | Dentist | 2205 W Lincoln Ave, Yakima, WA 98902-2437 | 2007-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740807890 | Plateau Kids Dentistry, LLC | Dentist | 2912 228th Ave Se Ste A, Sammamish, WA 98075-9305 | 2020-07-05 |
| 1528603503 | Ellen Polsky Dds and Bobby Virk Dmd, Ps | Dentist | 34704 11th Pl S Ste 101, Federal Way, WA 98003-8730 | 2019-11-13 |
| 1942843552 | Laura Stewart Dds Pllc | Dentist | 6821 Ne 181st St, Kenmore, WA 98028-5034 | 2019-10-26 |
| 1639736119 | Southcenter Children's Dentistry | Dentist | 411 Strander Blvd Ste 303, Tukwila, WA 98188-2924 | 2019-05-21 |
| 1770147001 | Kaitlin Neste Pllc | Dentist | 360 Tormey Ln Ne Ste 198, Bainbridge Island, WA 98110-1990 | 2019-04-22 |
| 1124511126 | Roger Lucas, P.s. | Dentist | 3806 116th St. Ne, Marysville, WA 98271 | 2018-06-13 |
| 1497248017 | Jinju Song Dmd Pllc | Dentist | 9707 Ne 119th Way, Kirkland, WA 98034-8955 | 2018-06-08 |
| 1861999864 | Peter Douglas | Dentist | 32105 1st Ave S Ste B3, Federal Way, WA 98003-5719 | 2018-04-07 |
| 1669994042 | Annikka Louise Frostad-thomas | Dentist | 700 Nw Gilman Blvd # E412, Issaquah, WA 98027-5395 | 2017-07-07 |
| 1831624402 | Minh Dau, Dds and Raymond Park, Dds Pllc | Dentist | 3105 Alderwood Mall Blvd, Suite 117, Lynnwood, WA 98036-4703 | 2017-04-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.