=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013876150
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DENTISTRY ON THE HEIGHTS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/15/2026
-----------------------------------------------------
Last Update Date | 01/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8308 E MILL PLAIN BLVD STE 101
-----------------------------------------------------
City | VANCOUVER
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98664-2066
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-256-6500
-----------------------------------------------------
Fax | 360-256-2651
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8308 E MILL PLAIN BLVD STE 101
-----------------------------------------------------
City | VANCOUVER
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98664-2066
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-256-6500
-----------------------------------------------------
Fax | 360-256-2651
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | KIRSTEN POLETE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 360-256-6500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------