JACY C NELSON D.D.S., P.S.
NPI 1154878668
Dentist in Renton, WA

Q: What is Jacy C Nelson D.D.S., P.S.'s NPI number?

The NPI number for Jacy C Nelson D.D.S., P.S. is 1154878668. It was assigned to this organization in the NPPES registry on September 1, 2016.

Q: What is Jacy C Nelson D.D.S., P.S.'s specialty?

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

Active since September 01, 2016

14300 SE PETROVITSKY RD, RENTON, WA 98058(253) 852-0202(253) 852-5361 Get Directions Write a Review

NPPES record last updated: May 11, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 11, 2026, Sep 1, 2016 (2 updates tracked since 2016).

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About Jacy C Nelson D.d.s., P.s. NPPES

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

JACY C NELSON D.D.S., P.S. (NPI 1154878668) is a healthcare organization registered as a dentist in Renton, Washington and active in the NPI registry since September 2016. The organization lists Jacy Craig Nelson, Owner, as its authorized official.

NPPES Registry Identity

NPI1154878668

Entity TypeOrganization

Primary Taxonomy122300000X

Legal Business NameJACY C NELSON D.D.S., P.S.

Location Address14300 SE PETROVITSKY RDRenton, WA 98058-8955

Mailing Address14300 Se Petrovitsky RdRenton, WA 98058-8955 · (253) 852-0206 · Fax (253) 852-5361

Phone(253) 852-0202

Fax(253) 852-5361

Organization SubpartNo

Authorized OfficialJacy Craig NelsonOwner · (253) 852-0206

Enumeration DateSeptember 1, 2016

Last NPPES UpdateMay 11, 20262 updates tracked since enumeration

NPPES CertifiedMay 11, 2026

✔ NPI 1154878668 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in WA · DE9342

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.

14300 SE PETROVITSKY RD, Renton, WA 98058

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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

Other Providers at the Same Location NPPES 8

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

DR. TOM LEE DDS

Dentist (General Practice)