Tyler B. Gundersen, Pllc
LBN: Gundersen Dental, Pllc
Tyler B. Gundersen, Pllc is an health care organization with primary practice located at 251 N. Chelan Ave , Wenatchee WA 98801. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Ambulatory Health Care Facilities / Dental. Dental Providers / Dentist is the primary health care specialty.
Gundersen Dental, Pllc can be contacted via phone (509) 663-4436, or through Gundersen, Tyler Burton via phone (509) 663-4436.
Contact Information
Primary practice address
251 N. Chelan Ave
Wenatchee WA 98801
Phone: (509) 663-4436
Fax: (509) 663-5974
Website:
Authorized official contact:
Name: Gundersen, Tyler Burton Doctor of Dental Surgery (DDS)
Phone: (509) 663-4436
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | ||
| Ambulatory Health Care Facilities / Dental | 261QD0000X | DE00010222 | Washington |
Profile Details
| NPI number | 1114470432 |
|---|---|
| LBN Legal business name | Gundersen Dental, Pllc |
| DBA Doing business as | Tyler B. Gundersen, Pllc |
| Authorized official | Gundersen, Tyler Burton Doctor of Dental Surgery (DDS) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 3rd, 2016 |
| Last updated | Mar 9th, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114470432 | NPPES |
| Washington | MEDICAID | 5048871 |
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