Herbert Todd DDS
Dentist in Lacey, WA. Organization (NPI-2).
NPI number1174059638
StatusActive
Last updated in NPPESMay 3, 2017
Details
- NPI
- 1174059638
- Entity type
- Organization (NPI-2)
- Legal business name
- Herbert Todd DDS
- Organization subpart
- No
- Enumeration date
- May 3, 2017
- Last updated
- May 3, 2017
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 7656 | WA | Yes |
Practice location
4445 Lacey Blvd SeLacey, WA 98503-5716
Phone 360-491-2532 · Fax 360-923-9565
Mailing address
4445 Lacey Blvd SeLacey, WA 98503-5716
Phone 360-491-2532 · Fax 360-923-9565
Authorized official
Danita Clark
Office Manager
3604912532
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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