HARDIE DENTISTRY FOR KIDS (NPI# 1538480215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538480215 |
| Entity Type | Organization |
| Organization Name | HARDIE DENTISTRY FOR KIDS |
| Practice Address |
925 Ne 136th Ave Suite 101 Vancouver WA 98684-0896 |
| Mailing Address |
12800 Ne 4th St Apt 58 Vancouver WA 98684-5051 |
| Practice Telephone | 3606945559 |
| Practice Fax Number | 3606945557 |
| Mailing Telephone | 3602414361 |
| Mailing Fax Number | 3609645557 |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2010-06-17 |
| Authorized Official Name | DR. WILLIE M HARDIE (PEDIATRIC DENTIST/ OWNER) |
| Authorized Official Telephone | 3602414361 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DE00008741 | WA | Dental Providers |
| Street Address |
925 NE 136TH AVE SUITE 101 |
| City | VANCOUVER |
| State | WA |
| Zip Code | 98684-0896 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093891533 | Willie M Hardie | Dentist | 925 Ne 136th Ave, Suite 101, Vancouver, WA 98684-0896 | 2006-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285291849 | Pacifica Sylvan Park LLC | Alzheimer Center (Dementia Center) | 2400 Ne 112th Avenue, Vancouver, WA 98684 | 2019-05-20 |
| 1699242826 | Heidi Ericka Jackson | Registered Nurse | 15606 Ne 12th Way, Vancouver, WA 98684 | 2018-10-25 |
| 1477076727 | Brian Benasa Bardeloza | Dentist | 605 Se 164th Ave Ste 103, Vancouver, WA 98684 | 2017-07-19 |
| 1992226062 | Judith Moreno-castro | Massage Therapist | 2501 Ne 138th Ave., #60, Vancouver, WA 98684 | 2017-06-29 |
| 1346790706 | Samuel Joonsang Lee | Registered Nurse | 501 Se 172nd Ave Ste 210, Vancouver, WA 98684 | 2016-10-10 |
| 1912353178 | Cheryl A. Hamilton-jefferson | Counselor | 11818 Se Mill Plain Blvd Ste 311g, Vancouver, WA 98684 | 2016-05-06 |
| 1063866424 | Kim Forgione | Optometrist | 1900 Ne 162nd Ave Ste D103, Vancouver, WA 98684 | 2016-04-21 |
| 1700254257 | Desiree Haggart | Registered Nurse | 406 Se 131st St., Suite A101, Vancouver, WA 98684 | 2015-09-14 |
| 1215318068 | Paige M. King | Behavioral Analyst | 11818 Se Mill Plain Blvd Ste 203, Vancouver, WA 98684 | 2015-06-17 |
| 1417354366 | Amanda Hilkey, Lmp | Massage Therapist | 108 Se 24th Ave, Ste 9, Vancouver, WA 98684 | 2014-11-20 |
| Find all providers in zip 98684 | ||||
| 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 |
|---|---|---|---|---|
| 1043563661 | Amna Shebani, D.d.s., P.C. | Dentist | 1405 S.e. 164th Avenue, Suite # 203, Vancouver, WA 98683 | 2012-10-19 |
| 1336436906 | Justin Anthony Heaton | Dentist | 900 Ne 139th St Ste 106, Vancouver, WA 98685 | 2011-07-05 |
| 1285798728 | Frank J Foreman Dds Ps | Dentist | 11700 Ne 95th St, Suite 120, Vancouver, WA 98682-2399 | 2006-12-20 |
| 1841353638 | Richard L. Grabowsky | Dentist | 1933 Fort Vancouver Way, Vancouver, WA 98663-3529 | 2006-12-19 |
| 1093891533 | Willie M Hardie | Dentist | 925 Ne 136th Ave, Suite 101, Vancouver, WA 98684-0896 | 2006-10-27 |
| 1396756029 | Peter Lubisich | Dentist | 300 Se 120th Ave Ste 100, Vancouver, WA 98683-4067 | 2006-08-10 |
| 1255348181 | David S Neil | Dentist | 2501 Ne 134th St, Vancouver, WA 98686-3026 | 2006-08-02 |
| 1801831508 | Pamela Butler | Dentist | 3205 Se 192nd Ave, Suite#100, Vancouver, WA 98683 | 2006-06-17 |
| 1396134185 | Renato De Luna, Dmd | Dentist | 11700 Ne 95th St, Suite 120, Vancouver, WA 98682-2399 | 2015-01-15 |
| 1033460183 | Gagneja, Bds, Pllc | Dentist | 601 Se 117th Ave, Ste 150, Vancouver, WA 98683-5297 | 2012-09-28 |
| Find all providers in VANCOUVER | ||||
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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.