Heaton, Justin Anthony
Heaton, Justin Anthony is an individual health care provider with primary practice located at 900 Ne 139Th St Ste 106 , Vancouver WA 98685. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Heaton, Justin Anthony can be contacted via phone (360) 604-9000.Contact Information
Primary practice address
900 Ne 139Th St Ste 106
Vancouver WA 98685
Phone: (360) 604-9000
Fax: (360) 573-1417
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | DE60739379 | Washington |
Profile Details
| NPI number | 1336436906 |
|---|---|
| LBN Legal business name | Heaton, Justin Anthony |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 5th, 2011 |
| Last updated | Jun 7th, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336436906 | NPPES |
| Colorado | Other | 00202327 | COLORADO DENTAL BOARD |
| Colorado | Other | 8021817-9922 | COLORADO DENTAL BOARD |
| Colorado | Other | DD4183 | COLORADO DENTAL BOARD |
| Colorado | Other | 2015004889 | COLORADO DENTAL BOARD |
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