Unknown Individual – General Practice Dentistry, NPI 1609804475

Unknown Individual is a healthcare provider. based in Longview, Washington. specializing in General Practice Dentistry. They hold a License No. DE00003884 (WA). The NPI Number for Unknown Individual is 1609804475

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1609804475
Phone
(360) 636-3892
Address
1057 12TH AVE
Deactivation Date
24 March 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1057, 12th Avenue, Longview, Cowlitz County, Washington, 98632, United States

    LONGVIEW, WA 986322509

    Phone: (360) 636-3892

    Fax: (360) 414-1114

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98632)

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Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1609804475 uniquely identifies Unknown Individual in U.S. healthcare data.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
How should patients interpret Unknown Individual's specialty?
The extract shows General Practice Dentistry for Unknown Individual. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Longview, Washington?
For routing, start with Longview, Washington for Unknown Individual, then verify phone and hours locally.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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