WJM DENTAL INC (NPI# 1407166655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407166655 |
| Entity Type | Organization |
| Organization Name | WJM DENTAL INC |
| Other Organization Name | WILLIE MCLULLUM DDS - CHILDREN'S DENTISTRY |
| Practice Address |
4002 South M Street Suite A Tacoma WA 98418 |
| Practice Telephone | 2534740606 |
| Mailing Telephone | 2534740606 |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2012-12-18 |
| Authorized Official Name | DR. WILLIE JAMES MCCULLUM (DENTIST/OWNER) |
| Authorized Official Telephone | 2534740606 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
8920 | WA | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
6326 | WA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 5050273 | 05 |
| Other Name | Type Code |
|---|---|
| Willie McLullum DDS - Children's Dentistry | Other Name - Individual/Organization |
| Street Address |
4002 SOUTH M STREET SUITE A |
| City | TACOMA |
| State | WA |
| Zip Code | 98418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083240287 | Zindt Chiropractic Center Pllc | Chiropractor | 3819 S. M St., Tacoma, WA 98418 | 2020-03-19 |
| 1649756792 | Jaime Armenta | Counselor | Tacoma-pierce County Health Department, 3629 South D Street, Tacoma, WA 98418 | 2018-07-12 |
| 1255453890 | Stephen Joseph Bauml | Chiropractor | 212 So 37th St, Tacoma, WA 98418 | 2007-04-04 |
| 1710015912 | Lincoln Pharmacy LLC | Pharmacy | 821b S 38th St, Tacoma, WA 98418 | 2007-03-01 |
| 1104961093 | Still Well Chiropractic Clinic Inc | Chiropractor | 4537 S Yakima, Tacoma, WA 98418 | 2007-02-20 |
| 1497813851 | Penelope S. Zindt | Chiropractor | 3819 So M, Tacoma, WA 98418 | 2006-12-05 |
| 1902987092 | Donna Leigh Daeschner | Dentist | 4001 So. Yakima Avenue, Tacoma, WA 98418 | 2006-10-17 |
| 1083622971 | Willie James Mccullum | Dentist | 4002 South 'm' Street, Suite A, Tacoma, WA 98418 | 2006-08-04 |
| 1871500322 | Michelle Gray Marconi | Chiropractor | 4537 So. Yakima Ave, Tacoma, WA 98418 | 2006-08-01 |
| 1780604009 | Living & Wellness Centers Ps | Physical Medicine & Rehabilitation | 3716 Pacific Ave, #e, Tacoma, WA 98418 | 2006-07-20 |
| Find all providers in zip 98418 | ||||
| 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 |
|---|---|---|---|---|
| 1528672078 | Christopher Hieu-thanh Nguyen | Dentist | Madigan Annex Second Floor Building 9900, Tacoma, WA 98431-0001 | 2020-09-02 |
| 1699308619 | Gaurav Dudeja Pllc | Dentist | 5038 Tacoma Mall Blvd Ste A, Tacoma, WA 98409-7103 | 2020-02-18 |
| 1477032035 | Sampada Jayant Deshpande | Dentist | 4811 Wa Tau Ga Ave Ne, Tacoma, WA 98422-1799 | 2018-08-14 |
| 1962996272 | William Thomas Frei | Dentist | 9900 Lincoln St, 2nd Floor, Attn: Credentials Office, Us Army Dentac, Tacoma, WA 98327 | 2018-06-20 |
| 1720598949 | Alyssa Christine Meister Burns | Dentist | 9900 Lincoln Street (2nd Floor), Tacoma, WA 98431-0001 | 2017-10-02 |
| 1528503141 | Ajaipal Singh Sekhon, Dds, Pllc | Dentist | 2716 N 31st St, Tacoma, WA 98407-6405 | 2017-01-05 |
| 1730543240 | Dale L. Vanderschelden, Dds Chartered | Dentist | 5003 Tacoma Mall Blvd Ste 103, Tacoma, WA 98409-7120 | 2016-04-11 |
| 1639552110 | Philip Henzlik | Dentist | 9900 Lincoln St. 2nd Floor, Us Army Dentac, Tacoma, WA 98327 | 2015-07-02 |
| 1639599566 | Adam Yang Dds Ps | Dentist | 15 Oregon Ave Ste 106, Tacoma, WA 98409-7462 | 2014-04-17 |
| 1265778484 | Richard Guzha Dds LLC | Dentist | 2617 6th Ave, Tacoma, WA 98406-7204 | 2012-12-15 |
| Find all providers in TACOMA | ||||
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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.