Provider Demographics
NPI:1649642638
Name:NORTHWEST IMPLANTS AND SLEEP DENTISTRY
Entity type:Organization
Organization Name:NORTHWEST IMPLANTS AND SLEEP DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:PAXTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-242-3336
Mailing Address - Street 1:9911 N. NEVADA AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-2500
Mailing Address - Country:US
Mailing Address - Phone:509-242-3336
Mailing Address - Fax:866-554-1392
Practice Address - Street 1:9911 N. NEVADA AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-2500
Practice Address - Country:US
Practice Address - Phone:509-242-3336
Practice Address - Fax:866-554-1392
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARK PAXTON DDS PS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-10-29
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty