EVERGREEN FAMILY DENTISTRY
NPI 1497879001
Dentist in Monroe, WA
NPI Status: Active since March 19, 2007
Contact Information
17798 147TH ST SE
MONROE, WA
ZIP 98272
Phone: (360) 805-0211
Fax: (360) 863-9222
- Organization
- Dentist
- Accepts Insurance
- CLIA Number: 50D0690275
- CLIA Cert. Type: Hospital
- CLIA Exp. Date: 04-04-2028
About EVERGREEN FAMILY DENTISTRY
This page provides the complete NPI Profile along with additional information for Evergreen Family Dentistry, a provider established in Monroe, Washington operating as a Dentist. The healthcare provider is registered in the NPI registry with number 1497879001 assigned on March 2007. The practitioner's primary taxonomy code is 122300000X with license number 7077 (WA). The provider is registered as an organization and their NPI record was last updated 5 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Glen A Monson Dds (Owner)
- NPI
- 1497879001
- Provider Name
- EVERGREEN FAMILY DENTISTRY
- Entity Type
- Organization
- Location Address
- 17798 147TH ST SE MONROE, WA 98272
- Location Phone
- (360) 805-0211
- Location Fax
- (360) 863-9222
- Mailing Address
- 17798 147TH ST SE MONROE, WA 98272
- Mailing Phone
- (360) 805-0211
- Mailing Fax
- (360) 863-9222
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-19-2007
- Last Update Date
- 08-22-2020
- Code Navigator
A dentist like Evergreen Family Dentistry is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist
- Taxonomy Code
- 122300000X
- Type
- Dental Providers
- License No.
- 7077
- License State
- WA
- Taxonomy Description
- 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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Premera Blue Cross Alaska One Gold - PPO
- Premera Blue Cross Preferred Bronze 5800 HSA - PPO
- Premera Blue Cross Preferred Bronze 6350 - PPO
- Premera Blue Cross Preferred Gold 1500 - PPO
- Premera Blue Cross Preferred Silver 4500 - PPO
- Premera Blue Cross Standard Bronze II - PPO
- Premera Blue Cross Standard Gold - PPO
- Premera Blue Cross Standard Silver - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 50D0690275
- Facility Type
- Hospital
- Certificate Effective Date
- October 03, 2018
- Certificate Expiration Date
- April 04, 2028
- Laboratory Director
- YANELBA TORIBIO
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Evergreen Family Dentistry after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 9 | 7 | 8 | 7 | 9 | 0 | 0 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 18 | 7 | 16 | 7 | 18 | 0 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 1 + 8 + 7 + 1 + 6 + 7 + 1 + 8 + 0 + 0 + 24 = 69 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 69 = 1 | 1 | ||||||||
The NPI number 1497879001 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1316213374 | EVERGREEN FAMILY DENTISTRY, INC. Organization | Durable Medical Equipment & Medical Supplies | 17798 147TH ST SE MONROE, WA 98272 (360) 805-0211 |
| 1477639375 | DR. ROBERT K PARK D.D.S. Individual | Dentist (General Practice) | 17798 147TH ST SE MONROE, WA 98272 (360) 605-0211 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1497879001, enumerated in the NPI registry as an "organization" on March 19, 2007
The provider is located at 17798 147th St Se Monroe, Wa 98272 and the phone number is (360) 805-0211
This medical organization specializes in Dentist with taxonomy code 122300000X
The provider might be accepting Accepts: Premera Blue Cross Blue Shield of Alaska. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 50D0690275 for a "hospital" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on March 19, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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