=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003782152
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ZACHARY P EHRMANTROUT PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/15/2025
-----------------------------------------------------
Last Update Date | 12/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6889 S EASTERN AVE STE 100A
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89119-4687
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-250-9402
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3233 36TH AVE NW
-----------------------------------------------------
City | OLYMPIA
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98502-3570
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-250-9402
-----------------------------------------------------
Fax | 360-250-9402
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ORTHODONTIST MEMBER
-----------------------------------------------------
Name | ZACHARY EHRMANTROUT
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 360-250-9402
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223X0400X
-----------------------------------------------------
Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------