LACEY DENTAL, LLC (NPI# 1831520162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831520162 |
| Entity Type | Organization |
| Organization Name | LACEY DENTAL, LLC |
| Other Organization Name | COMFORT DENTAL LACEY |
| Practice Address |
1110 Galaxy Dr Ne Lacey WA 98516-4763 |
| Practice Telephone | 2535371559 |
| Practice Fax Number | 2535365907 |
| Mailing Telephone | 2535371559 |
| Mailing Fax Number | 2535365907 |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2013-12-12 |
| Authorized Official Name | SCOTT PROBST (OWNER) |
| Authorized Official Telephone | 2535371559 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DE 60178653 | WA | Dental Providers |
| Other Name | Type Code |
|---|---|
| Comfort Dental Lacey | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | LACEY DENTAL, LLC | 1110 Galaxy Dr Ne Ste J, Lacey, WA 98516-4764 |
| Street Address |
1110 GALAXY DR NE |
| City | LACEY |
| State | WA |
| Zip Code | 98516-4763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730744210 | Michael Oropeza | Behavioral Analyst | 8282 28th Court Northeast, Suite A, Lacey, WA 98516 | 2019-05-09 |
| 1902361330 | Amanda Jessica Mae Allen | Behavioral Analyst | Basics Nw LLC, 8282 28th Ct Ne Suite A, Lacey, WA 98516 | 2019-02-11 |
| 1619459393 | Kayla-renee Williams | Behavioral Analyst | Basics Nw LLC 8282 28th Ct Ne, Suite A, Lacey, WA 98516 | 2018-08-30 |
| 1174004303 | Julie Ann Lisowski | Massage Therapist | 3532 Cuddy Ln Ne, Lacey, WA 98516 | 2018-08-26 |
| 1740700145 | Joseph Brandon Kimmel | Denturist | 5032 Beverly Dr Ne, Olympia, WA 98516 | 2017-06-27 |
| 1649649880 | Katie Cole | Behavioral Analyst | 8282 28th Ct Ne, Suite A, Basics Nw, LLC, Lacey, WA 98516 | 2015-09-17 |
| 1306234166 | Reza Tahernia | Dentist | 8050 Freedon Lane Ne, Suite C, Lacey, WA 98516 | 2015-01-02 |
| 1770997603 | Qualified Surgical Services Pllc | Surgery | 3697 Cameron Dr Ne, Lacey, WA 98516 | 2014-06-18 |
| 1184048688 | Stephanie Renee Hjortedal | Specialist/Technologist | 8750 Tallon Lane Ne., Lacey, WA 98516 | 2014-02-05 |
| 1295169811 | Teasha Corrado | Behavioral Analyst | 8282 28th Court Ne, Suite A, Lacey, WA 98516 | 2013-08-30 |
| Find all providers in zip 98516 | ||||
| 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 |
|---|---|---|---|---|
| 1407461825 | Jangsu Kiyoshi | Dentist | 3006 Mahogany St Ne, Lacey, WA 98516-5589 | 2020-09-11 |
| 1215584701 | Nisqually Reach Family Dentistry | Dentist | 2521 Marvin Rd Ne Ste G, Lacey, WA 98516-3153 | 2019-08-20 |
| 1386290641 | Mark Douglas Morrison | Dentist | 9321 Martin Way E Ste 101, Lacey, WA 98516-5928 | 2019-08-13 |
| 1144715293 | Jason Sholly | Dentist | 909 Sleater Kinney Rd Se Ste 3, Lacey, WA 98503-1103 | 2018-06-29 |
| 1952820607 | Luis Gustavo Acosta | Dentist | 5122 Yelm Hwy Se Ste E, Lacey, WA 98503-5037 | 2017-09-13 |
| 1306234166 | Reza Tahernia | Dentist | 8050 Freedon Lane Ne, Suite C, Lacey, WA 98516 | 2015-01-02 |
| 1336589506 | Joshua C Carpenter | Dentist | 3201 Willamette Dr Ne, Suite A, Lacey, WA 98516-1376 | 2013-07-02 |
| 1396973418 | Tyler R Burningham | Dentist | 8857 Windham Ct Ne, Lacey, WA 98516-3884 | 2009-06-26 |
| 1780847103 | Scott John Neuhaus | Dentist | 3925 Pacific Ave Se, Lacey, WA 98503-1108 | 2008-07-07 |
| 1588859425 | Family Dentistry At Hawks Prairie | Dentist | 9321 Martin Way E., Suite 101, Lacey, WA 98516 | 2007-09-13 |
| Find all providers in LACEY | ||||
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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.