Provider Demographics
NPI:1043765480
Name:CASHMERE DENTAL
Entity Type:Organization
Organization Name:CASHMERE DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEROY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HANKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:509-782-2297
Mailing Address - Street 1:201 COTTAGE AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CASHMERE
Mailing Address - State:WA
Mailing Address - Zip Code:98815-1616
Mailing Address - Country:US
Mailing Address - Phone:509-782-2297
Mailing Address - Fax:509-782-8012
Practice Address - Street 1:201 COTTAGE AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:CASHMERE
Practice Address - State:WA
Practice Address - Zip Code:98815-1616
Practice Address - Country:US
Practice Address - Phone:509-782-2297
Practice Address - Fax:509-782-8012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA6028526671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty