Provider Demographics
NPI:1710029376
Name:COOMBS, BECKY VAN GEMERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:BECKY
Middle Name:VAN GEMERT
Last Name:COOMBS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:COOK
Other - Last Name:VAN GEMERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2020 E 29TH AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-3957
Mailing Address - Country:US
Mailing Address - Phone:509-315-8500
Mailing Address - Fax:509-443-5456
Practice Address - Street 1:2020 E 29TH AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-3957
Practice Address - Country:US
Practice Address - Phone:509-315-8500
Practice Address - Fax:509-443-5456
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA102161223P0221X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5050166Medicaid