=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184413262
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HILLYARD AND NEIL, P.L.L.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/05/2025
-----------------------------------------------------
Last Update Date | 05/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 900 NE 139TH ST STE 106
-----------------------------------------------------
City | VANCOUVER
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98685-2519
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-604-9000
-----------------------------------------------------
Fax | 360-573-1417
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 900 NE 139TH ST STE 106
-----------------------------------------------------
City | VANCOUVER
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98685-2519
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-604-9000
-----------------------------------------------------
Fax | 360-573-1417
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PEDIATRIC DENTIST
-----------------------------------------------------
Name | TODD HILLYARD
-----------------------------------------------------
Credential | DDS/DMD
-----------------------------------------------------
Telephone | 360-604-9000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA1903X
-----------------------------------------------------
Taxonomy Name | Ambulatory Surgical Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1223P0221X
-----------------------------------------------------
Taxonomy Name | Pediatric Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------