Active NPI 1336122852 Individual Practitioner Male Practitioner

Dr. Randolph C Pearson , DDS

Dentist - General Practice • Walla Walla, WA

Professional Overview & Biography Verified Profile Summary

Dr. Randolph Pearson, DDS is a registered healthcare professional specializing in Dentist - General Practice in Walla Walla, WA. Practice services are available at 121 W POPLAR ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

121 W Poplar St
Ste C

Walla Walla, WA 993622871

Telephone 5095252850

Fax 5095296545

Associated Practice Facility / Clinic

🏢 Randolph C. Pearson, D.d.s., P.s. Facility NPI 1790706653

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Walla Walla, WA

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 21.3 Yrs

Regional Practice Density

29 Specialists

Practicing in Walla Walla, WA (3345 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License WA 4967

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

5512702 (WA)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners

Dr. Kyle Sullivan , DMD

Dentist - General Practice

NPI 1962558106

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location July 08, 2007

Registered at 121 W POPLAR ST, STE C, WALLA WALLA, WA 993622871 (Tel: 5095252850)

📍

Updated Business Mailing Address July 08, 2007

Registered at PO BOX 445, WAITSBURG, WA 993610445 (Tel: 5093378881)

👤

Provider Name / Credentials Updated July 08, 2007

Recorded as RANDOLPH PEARSON, D.D.S.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #4967 in WA)

🟢

Initial NPI Registration & Enumeration November 29, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1336122852

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: November 29, 2005

Last Update: July 08, 2007

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

Po Box 445

Waitsburg, WA 993610445

Phone: 5093378881

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.