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CLARK COUNTY DENTAL & DENTURE CLINIC
NPI 1962423129
Dentist - General Practice in Vancouver, WA

Active since July 22, 2006
2701 NE 114TH AVE, # K-6, VANCOUVER, WA 98684(360) 892-7107(360) 891-8361 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Clark County Dental & Denture Clinic NPPES

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

CLARK COUNTY DENTAL & DENTURE CLINIC (NPI 1962423129) is a healthcare organization registered as a general practice in Vancouver, Washington and active in the NPI registry since July 2006. The organization lists Sally Irene Fettig, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1962423129
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameCLARK COUNTY DENTAL & DENTURE CLINIC
Location Address2701 NE 114TH AVE, # K-6Vancouver, WA 98684-4289
Mailing Address2701 Ne 114th Ave, # K-6Vancouver, WA 98684-4289 · (360) 892-7107 · Fax (360) 891-8361
Phone(360) 892-7107
Fax(360) 891-8361
Organization SubpartNo
Authorized OfficialSally Irene FettigBusiness Manager · (360) 892-7107
Enumeration DateJuly 22, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1962423129 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in WA · DE00008735
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
2701 NE 114TH AVE, Vancouver, WA 98684
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Other Identifiers 5

Medicaid5048616WA
Medicaid5036074WA
Medicaid5047576WA
Medicaid5041082WA
Medicaid5026356WA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

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

BOGDAN N BODROUG, DDS, PS
Dentist
2701 NE 114TH AVE, SUITE 6
VANCOUVER, WA 98684
Clark County (503) 427-2984
CLARK COUNTY DENTAL & DENTURE CLINIC
Denturist
2701 NE 114TH AVE, # K-6
VANCOUVER, WA 98684
Clark County (360) 892-7107

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 Clark County Dental & Denture Clinic's NPI number?

The NPI number for Clark County Dental & Denture Clinic is 1962423129. It was assigned to this organization in the NPPES registry on July 22, 2006.

Where is Clark County Dental & Denture Clinic located?

Clark County Dental & Denture Clinic is located at 2701 NE 114th Ave # K-6, Vancouver, WA 98684. The listed phone number is (360) 892-7107.

What is Clark County Dental & Denture Clinic's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Clark County Dental & Denture Clinic was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.