Provider Demographics
NPI:1235191735
Name:PINSON, RONALD A (DMD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:A
Last Name:PINSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 38
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-0038
Mailing Address - Country:US
Mailing Address - Phone:360-293-2808
Mailing Address - Fax:360-293-0306
Practice Address - Street 1:601 O AVE
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-1747
Practice Address - Country:US
Practice Address - Phone:360-293-2808
Practice Address - Fax:360-293-0306
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000039851223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5052923Medicaid
WA821270OtherTRICARE
G8867274Medicare PIN
T02908Medicare UPIN