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CAMAS CENTER DENTAL CLINIC
NPI 1083980080
Dentist in Cusick, WA

Active since March 24, 2012CLIA 50D1075165 · Microscopy
1821 LECLERC RD N STE 1, CUSICK, WA 99119(509) 447-7111(509) 445-1152 Get Directions Write a Review

NPPES record last updated: September 13, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Camas Center Dental Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CAMAS CENTER DENTAL CLINIC (NPI 1083980080) is a healthcare organization registered as a dentist in Cusick, Washington and active in the NPI registry since March 2012. The organization holds a CLIA Microscopy certificate valid through April 4, 2028 and lists Tracy Lynn Birdtail, Am, as its authorized official.

NPPES Registry Identity

NPI1083980080
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameKALISPEL TRIBE OF INDIANS
Location Address1821 LECLERC RD N STE 1Cusick, WA 99119-5015
Mailing AddressPo Box 67Usk, WA 99180-0067 · (509) 447-7111 · Fax (509) 445-1152
Phone(509) 447-7111
Fax(509) 445-1152
Organization SubpartNo
Authorized OfficialTracy Lynn BirdtailAm · (509) 447-7112
Enumeration DateMarch 24, 2012
Last NPPES UpdateSeptember 13, 2023
NPPES CertifiedSeptember 13, 2023
✔ NPI 1083980080 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in WA · DE00009801
Definition
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.
1821 LECLERC RD N STE 1, Cusick, WA 99119
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Other Names 1

Doing Business AsCamas Center Dental Clinic

Other Identifiers 1

Medicaid5051537WA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 50D1075165

Camas Center Clinic · Cusick, WA
Active · expires Apr 4, 2028
CLIA Number50D1075165
Laboratory TypeOther
Certificate Effective DateApril 29, 2008
Certificate Expiration DateApril 4, 2028
Laboratory DirectorClayton G. Kersting
Laboratory Phone(509) 447-7111
Laboratory LocationCamas Center Clinic1821 North Le Clerc #1, Cusick, WA 99119
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BETH MCQUINN ND
Naturopath
1821 LECLERC RD N STE 1
CUSICK, WA 99119
Pend Oreille County (509) 447-7111
OLIVIA SHAWNEA LOW LPN
Licensed Practical Nurse
1821 LECLERC RD N STE 1
CUSICK, WA 99119
Pend Oreille County (509) 447-7111
KALISPEL INDIAN COMMUNITY OF THE KALISPEL RESERVATION WASHINGTON
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
1821 LECLERC RD N STE 1
CUSICK, WA 99119
Pend Oreille County (509) 447-7111
JENNIFER MARIE TACKITT APRN
Nurse Practitioner (Family)
1821 LECLERC RD N STE 1
CUSICK, WA 99119
Pend Oreille County (509) 447-7111
DEBORAH ANN GILSTRAP LMT
Massage Therapist
1821 LECLERC RD N STE 1
CUSICK, WA 99119
Pend Oreille County (509) 445-7111
JALEE PALMER RN
Registered Nurse
1821 LECLERC RD N STE 1
CUSICK, WA 99119
Pend Oreille County (509) 447-7204
APRIL R SATTLEEN CMA
Community Health Worker
1821 LECLERC RD N STE 1
CUSICK, WA 99119
Pend Oreille County (509) 447-7111

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kalispel Tribe Of Indians's NPI number?

The NPI number for Kalispel Tribe Of Indians is 1083980080. It was assigned to this organization in the NPPES registry on March 24, 2012. The provider is doing business as Camas Center Dental Clinic.

Where is Kalispel Tribe Of Indians located?

Kalispel Tribe Of Indians is located at 1821 Leclerc Rd N Ste 1, Cusick, WA 99119. The listed phone number is (509) 447-7111.

What is Kalispel Tribe Of Indians's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Does Kalispel Tribe Of Indians hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 50D1075165) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kalispel Tribe Of Indians was last updated on September 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.