SALMON CREEK ORAL & MAXILLOFACIAL SURGERY,LLC (NPI# 1083849913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083849913 |
| Entity Type | Organization |
| Organization Name | SALMON CREEK ORAL & MAXILLOFACIAL SURGERY,LLC |
| Practice Address |
14411 Ne 20th Ave Suite 111 Vancouver WA 98686-6431 |
| Practice Telephone | 3606952400 |
| Practice Fax Number | 3609061116 |
| Mailing Telephone | 3606952400 |
| Mailing Fax Number | 3609061116 |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2009-11-19 |
| Authorized Official Name | CRAIG W WONG (OWNER/PRESIDENT) |
| Authorized Official Telephone | 3606952400 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
WA5774 | WA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 5049937 | 05 |
| Street Address |
14411 NE 20TH AVE SUITE 111 |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98686-6431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841228061 | Craig William Wong | Dentist | 14411 Ne 20th Ave, Suite 100, Vancouver, WA 98686-6431 | 2006-06-28 |
| 1124438684 | Vancouver Dental Surgery Center | Clinic/Center | 14411 Ne 20th Ave, Suite 107, Vancouver, WA 98686-6431 | 2014-05-05 |
| 1417261322 | Rhonda R Dojan | Audiologist | 14411 Ne 20th Ave, Ste 101, Vancouver, WA 98686-6431 | 2010-08-03 |
| 1912198748 | Vancouver Ear, Nose & Throat Head & Neck Surgery Clinic, Ps | Clinic/Center | 14411 Ne 20th Ave, Suite 101, Vancouver, WA 98686-6431 | 2007-08-07 |
| 1821289653 | Vancouver Ear, Nose & Throat Head & Neck Surgery Clinic, Ps | Clinic/Center | 14411 Ne 20th Ave, Suite 101, Vancouver, WA 98686-6431 | 2007-08-07 |
| 1487854618 | Vancouver Ent & Ent of The Northwest Pllc | Clinic/Center | 14411 Ne 20th Ave, Ste 101, Vancouver, WA 98686-6431 | 2007-07-25 |
| 1396942090 | Salmon Creek Oral Surgery & Periodontics | Dentist | 14411 Ne 20th Ave, Suite 111, Vancouver, WA 98686-6431 | 2007-06-27 |
| 1861556649 | Christopher P. Moor | Audiologist | 14411 Ne 20th Ave, Suite 101, Vancouver, WA 98686-6431 | 2006-12-19 |
| 1861587719 | Vancouver Ent and Ent of The Northwest Pllc | Clinic/Center | 14411 Ne 20th Ave, Suite 101, Vancouver, WA 98686-6431 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154891117 | Dorota Bozena Barton | Speech-Language Pathologist | 2121 Ne 139th Street Mob A, Suite 200, Vancouver, WA 98686 | 2018-12-03 |
| 1881161818 | Michelle Wolfe | Dental Assistant | A101, 1484, 14313 Ne 20th Ave, Vancouver, WA 98686 | 2018-10-29 |
| 1306321237 | Rainier Springs Physician Group, LLC | General Practice | 2805 Ne 129th Street, Vancouver, WA 98686 | 2018-09-26 |
| 1801382387 | Kristopher K Kostenko | Dentist | 14201 Ne 20th Ave Ste A101, Vancouver, WA 98686 | 2018-07-08 |
| 1689164071 | Tegan Mills | Occupational Therapist | 7101 Ne 109th Street, Apt 64, Vancouver, WA 98686 | 2018-05-11 |
| 1164924122 | Kate Kristin Lawrence | Speech-Language Pathologist | 2215 Ne 104th St, Vancouver, WA 98686 | 2018-03-06 |
| 1437609567 | Elina Baranets | Registered Nurse | 14204 Ne Salmon Creek Avenue, Vancouver, WA 98686 | 2016-10-13 |
| 1386039550 | Sean Vikram Bhatia | Internal Medicine | Kaiser Salmon Creek, 14406 Ne 20th Ave, Vancouver, WA 98686 | 2015-04-03 |
| 1376988642 | Lindsay Hussey-andersen | Orthopaedic Surgery | 2525 Ne 139th St Ste 140, Vancouver, WA 98686 | 2013-05-01 |
| 1710253109 | Legacy Salmon Creek Hospital | Speech-Language Pathologist | 2121 Ne 139th St., Mob A, Ste 200, Vancouver, WA 98686 | 2012-03-29 |
| Find all providers in zip 98686 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740744374 | Thompson Ferguson Schrack Pllc | Dentist | 7604 Ne 5th Ave Ste 114, Vancouver, WA 98665-8200 | 2019-01-28 |
| 1942427828 | Brandon Scott Rehrer | Dentist | 3215 Se 192nd Ave Ste 112, Vancouver, WA 98683-1469 | 2007-04-20 |
| 1801919527 | Lyle Wilfred Nelson | Dentist | 3215 Se 192nd Ave, Suite 112, Vancouver, WA 98683-1469 | 2007-04-09 |
| 1952324527 | Thomas Michael Kreger | Dentist | 406b Se 131st Avenue, Suite 201, Vancouver, WA 98683-4004 | 2006-07-25 |
| 1841228061 | Craig William Wong | Dentist | 14411 Ne 20th Ave, Suite 100, Vancouver, WA 98686-6431 | 2006-06-28 |
| 1689988545 | Brandon Rehrer Dds Pllc | Dentist | 3215 Se 192nd Ave Ste 112, Vancouver, WA 98683-1469 | 2010-08-03 |
| 1790881910 | Gregory W Boice | Dentist | 300 Se 120th Ave, #600, Vancouver, WA 98683-4090 | 2006-09-15 |
| 1639275878 | Martin A Seidenschmid | Dentist | 300 Se 120th Ave, Suite 600, Vancouver, WA 98683-4090 | 2006-09-15 |
| 1225134497 | Daniel R Dorsey | Dentist | 300 Se 120th Ave, Suite 600, Vancouver, WA 98683-4090 | 2006-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619657 | Washington Jaw and Facial Surgery Pllc | Dentist | 451 Duvall Ave Ne Ste 100, Renton, WA 98059-4675 | 2020-11-02 |
| 1952909145 | Calley Christie Dmd Pllc | Dentist | 275 Sw 160th St Ste 115, Burien, WA 98166-3003 | 2020-10-11 |
| 1679197016 | Tae Youn Dds Md Pllc | Dentist | 15808 Mill Creek Blvd Ste 202, Mill Creek, WA 98012-1500 | 2020-06-02 |
| 1417416728 | Sam Wise | Dentist | 1538 11th Ave Lowr Columbia, Longview, WA 98632 | 2019-03-16 |
| 1053875096 | John K Tidwell Dds and Elizabeth A Kutcipal Dds Pllc | Dentist | 1801 Nw Market St Ste 108, Seattle, WA 98107-3909 | 2019-01-23 |
| 1255803904 | Edwards, Johnson, Johnson & Johnson D.d.s., P.l.l.c. | Dentist | 601 S Carr Rd Ste 300, Renton, WA 98055-5840 | 2018-12-19 |
| 1104396969 | Mark Stivers, Dds, Inc., P.s. | Dentist | 12728 19th Ave Se Ste 101, Everett, WA 98208-6526 | 2018-12-04 |
| 1144797499 | Washington Jaw and Facial Surgery Pllc | Dentist | 1370 116th Ave Ne Ste 101, Bellevue, WA 98004-3825 | 2018-10-25 |
| 1780151027 | Washington Jaw and Facial Surgery Pllc | Dentist | 2111 N Northgate Way Ste 105, Seattle, WA 98133-9018 | 2018-10-25 |
| 1043728827 | Lance D Keyes Dds | Dentist | 32650 State Route 20 Ste E106, Oak Harbor, WA 98277 | 2018-01-16 |
| Find all providers with the same taxonomy | ||||
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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.