DR. DERRIK PALMER STARK (NPI# 1346574316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346574316 |
| Entity Type | Individual |
| Full Name | DR. DERRIK PALMER STARK |
| Credential | DDS |
| Practice Address |
820 Ocean Beach Hwy Suite 110 Longview WA 98632-4080 |
| Practice Telephone | 3605770566 |
| Mailing Telephone | 3605770566 |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2009-09-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DE 60094586 | WA | Dental Providers |
| Street Address |
820 OCEAN BEACH HWY SUITE 110 |
| City | LONGVIEW |
| State | WA |
| Zip Code | 98632-4080 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710046610 | Jeffrey S Tack | Optometrist | 820 Ocean Beach Hwy, Suite 100, Longview, WA 98632-4011 | 2006-12-06 |
| 1285093385 | Smiles Dental Group, PC | Dentist | 820 Ocean Beach Hwy, Suite 110, Longview, WA 98632-4080 | 2016-02-17 |
| 1407220916 | Jackie Renee Kiser | Massage Therapist | 820 Ocean Beach Hwy, Ste 116, Longview, WA 98632-4080 | 2015-11-20 |
| 1346517570 | Riverwoods Chiropractic & Massage, Pllc | Chiropractor | 820 Ocean Beach Hwy, Suite 116, Longview, WA 98632-4080 | 2011-11-16 |
| 1093020778 | Jeromy R. Dixson, D.m.d., P.s. | Dentist | 820 Ocean Beach Hwy, Suite 110, Longview, WA 98632-4080 | 2010-08-18 |
| 1386878965 | Kristi Kaylynn Poe | Optometrist | 820 Ocean Beach Hwy, Suite 100, Longview, WA 98632-4080 | 2009-05-11 |
| 1700051760 | Jared Doman | Dentist | 820 Ocean Beach Hwy, Suite 110, Longview, WA 98632-4080 | 2008-04-29 |
| 1861535197 | Longview Eye & Vision | Optometrist | 820 Ocean Beach Hwy, Suite 100, Longview, WA 98632-4011 | 2007-02-15 |
| 1508925405 | Terence O Tack | Optometrist | 820 Ocean Beach Hwy, Suite 100, Longview, WA 98632-4011 | 2006-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992366 | Honor Senior Care LLC | Home Health Aide | 1135 3rd Ave, Ste S101, Longview, WA 98632 | 2020-11-03 |
| 1417416728 | Sam Wise | Dentist | 1538 11th Ave Lowr Columbia, Longview, WA 98632 | 2019-03-16 |
| 1053870717 | Matthew Johnson | Physician Assistant | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 | 2019-03-12 |
| 1295205367 | Abid Valji | Occupational Therapist | Americana Health and Rehabilitation Center, 917 7th Ave, Longview, WA 98632 | 2018-11-30 |
| 1184106437 | Peacehealth | Durable Medical Equipment & Medical Supplies | Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 | 2018-09-04 |
| 1982186318 | Linda Joan Mason | Licensed Practical Nurse | 1153 23rd Ave, Longview, WA 98632 | 2018-09-01 |
| 1891291910 | Ellen Sumner Hornbeak | Physical Therapist | 200 Triangle Shopping Ctr Ste 270, Longview, WA 98632 | 2018-04-05 |
| 1700399961 | Johnna Joyce Knapp | Speech-Language Pathologist | 2615 Lilac St, Longview, WA 98632 | 2017-11-09 |
| 1841711868 | Deborah Annette Burzynski | Registered Nurse | 1057 12th Avenue, Longview, WA 98632 | 2017-06-29 |
| 1598291122 | Cheyenne West | Counselor | 1616 10th Avenue, Longview, WA 98632 | 2017-05-02 |
| Find all providers in zip 98632 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124681564 | Travis L Kendall Dds Pllc | Dentist | 444 Forest Sq Ste E, Longview, TX 75605-4463 | 2019-04-22 |
| 1609349612 | Sds-bill Owens Pkwy Pllc | Dentist | 3 Doctor Cir, Longview, TX 75605-5050 | 2019-01-03 |
| 1699272088 | Gur Simran Aurora | Dentist | 3052 N Eastman Rd Ste 108, Longview, TX 75605-5013 | 2018-04-11 |
| 1801301643 | Sds-bill Owens Pkwy Pllc | Dentist | 2840 Bill Owens Pkwy Ste B, Longview, TX 75605-2150 | 2017-12-01 |
| 1780104836 | Timothy John Gengel | Dentist | 444 Forest Sq Ste 1, Longview, TX 75605-4400 | 2017-06-20 |
| 1154878551 | Olivia Joelle Ndoutoume | Dentist | 2801 Bill Owens Pkwy, Apt 279, Longview, TX 75605-2115 | 2016-09-02 |
| 1659793396 | Jared A Franson, Dmd, Ps | Dentist | 2020 9th Ave Ste A, Longview, WA 98632-4072 | 2014-01-15 |
| 1619300332 | Robert Byron Shelton | Dentist | 905 Walnut Hill Dr Ste 1, Longview, TX 75605-5084 | 2013-08-16 |
| 1790128189 | Shiney George | Dentist | 710 Estes Dr, Longview, TX 75602-6120 | 2013-04-16 |
| 1740560911 | Mark D Teigen Dds Ps | Dentist | 1105 14th Ave, Longview, WA 98632-3016 | 2011-08-19 |
| Find all providers in LONGVIEW | ||||
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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.