Provider Demographics
NPI:1912230152
Name:GEOFFREY T PING, PS
Entity type:Organization
Organization Name:GEOFFREY T PING, PS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:T
Authorized Official - Last Name:PING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-999-6144
Mailing Address - Street 1:331 SUNTIDES BLVD
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-9025
Mailing Address - Country:US
Mailing Address - Phone:206-999-6144
Mailing Address - Fax:
Practice Address - Street 1:250 N MISSION ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2004
Practice Address - Country:US
Practice Address - Phone:206-999-6144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-04
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00010971261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental