BRIDGEPORT DENTAL ARTS (NPI# 1265535652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265535652 |
| Entity Type | Organization |
| Organization Name | BRIDGEPORT DENTAL ARTS |
| Other Organization Name | GARY R SHAW DDS |
| Practice Address |
4103 Bridgeport Way W Suite A University Place WA 98466 |
| Practice Telephone | 2535654474 |
| Practice Fax Number | 2535656848 |
| Mailing Telephone | 2535654474 |
| Mailing Fax Number | 2535656848 |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2014-10-08 |
| Authorized Official Name | GARY R SHAW (DENTIST OWNER) |
| Authorized Official Telephone | 2535654474 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 1431549922 | UT | Dental Providers |
| Y | 122300000X | Dentist | DE00006436 | WA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | WASTEMPLOYMENT | 601484620 | 01 |
| Other Name | Type Code |
|---|---|
| Gary R Shaw DDS | Other Name - Individual/Organization |
| Street Address |
4103 BRIDGEPORT WAY W SUITE A |
| City | UNIVERSITY PLACE |
| State | WA |
| Zip Code | 98466 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760775647 | Deborah J Gillham | Specialist | 4103 Bridgeport Way W, University Place, WA 98466-4300 | 2011-05-25 |
| 1154587087 | Gary R Shaw | Dentist | 4103 Bridgeport Way W, Ste A, University Place, WA 98466-4300 | 2008-07-30 |
| 1982723029 | Elena Walmer | Specialist | 4103 Bridgeport Way W, Suite C, University Place, WA 98466-4300 | 2007-03-28 |
| 1013033588 | Tatiana Shiyan | Specialist | 4103 Bridgeport Way W, Suite C, University Place, WA 98466-4300 | 2007-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306499215 | Julie Mccartney | Counselor | 7610 40th St W Ste 20, University Place, WA 98466 | 2019-07-19 |
| 1033682752 | Jms Corporate Services Group | In Home Supportive Care | 2621 70th Avenue West, Suite C, University Place, WA 98466 | 2019-01-04 |
| 1992270243 | Kathleen Marie Kulman | Massage Therapist | 4113 Bridgeport Avenue, Suite B, Tacoma, WA 98466 | 2018-10-12 |
| 1518441674 | Michala Lin Dymond-shaw | Speech-Language Pathologist | 3725 Grandview Dr W, University Place, WA 98466 | 2018-09-24 |
| 1770001133 | Micky Patrick Cates | Physician Assistant | 1924 70th Ave West, Apt E5, University Place, WA 98466 | 2017-09-06 |
| 1386160984 | Stephanie Herrala | Dentist | Okubo Dental Clinic 11582 C St, Jblm, WA 98466 | 2017-08-16 |
| 1033581640 | Jay Hyuck Sung | Dentist | 3670 Bridgeport Way W, Unit B, University Place, WA 98466 | 2015-10-22 |
| 1174951867 | Adrienne Holliday | Occupational Therapy Assistant | 3717 Grandview Drive W, University Place, WA 98466 | 2013-10-16 |
| 1598106650 | Maricris Pang Espino | Registered Nurse | 1541 Cottonwood Avenue, Fircrest, WA 98466 | 2013-07-17 |
| 1417393653 | Nurhan Karakas | Counselor | 9330 59th Ave Sw, Lakewood, WA 98466 | 2013-05-15 |
| Find all providers in zip 98466 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326692013 | Gentai Ni | Dentist | 8100 27th St W, University Place, WA 98466-2717 | 2019-07-30 |
| 1972058428 | Pacheco & Henry Dds Ps | Dentist | 4620 Bridgeport Way W Ste B, University Place, WA 98466-4237 | 2016-08-24 |
| 1992050942 | Joseph Eric Janaszak | Dentist | 4115 Bridgeport Way W Ste E, University Place, WA 98466-4331 | 2012-07-16 |
| 1467688861 | Thomas L Morales | Dentist | 3838 Bridgeport Way W, University Place, WA 98466-4416 | 2009-06-01 |
| 1790869527 | Spencer Moser Willardsen | Dentist | 8100 27th St West, University Place, WA 98466-2717 | 2006-10-25 |
| 1093813073 | Mark W Arnold | Dentist | 6706 24th St W, University Place, WA 98466 | 2006-09-21 |
| 1700984440 | Jerry L Walker | Dentist | 4303 Bridgeport Way W, University Place, WA 98466-4334 | 2006-09-20 |
| 1770595712 | Michael Ernest Martin | Dentist | 4303 Bridgeport Way West, University Place, WA 98466 | 2006-08-11 |
| 1831672187 | Colin Davis | Dentist | 3708 Bridgeport Way W, University Place, WA 98466-4419 | 2018-09-12 |
| 1154849735 | Oveys Hedayati Zafarghandi | Dentist | 3838 Bridgeport Way W, University Place, WA 98466-4416 | 2017-09-05 |
| Find all providers in UNIVERSITY PLACE | ||||
| City | UNIVERSITY PLACE |
| Zip Code | 98466 |
Please comment or provide details below to improve the information on BRIDGEPORT DENTAL ARTS.
| 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.