TACOMA DENTAL AND IMPLANT CENTER PS (NPI# 1972918399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1972918399 |
Entity Type | Organization |
Organization Name | TACOMA DENTAL AND IMPLANT CENTER PS |
Other Organization Name | TACOMA DENTAL AND IMPLANT CENTER PS |
Practice Address |
4704 South Oakes St #103 Tacoma WA 98409 |
Mailing Address |
4704 S Oakes St Ste 103 Tacoma WA 98409-6400 |
Practice Telephone | 2534720152 |
Mailing Telephone | 2534720152 |
Enumeration Date | 2014-06-24 |
Last Update Date | 2014-06-24 |
Authorized Official Name | DR. YURIY BAGDASAROV (OWNER) |
Authorized Official Telephone | 2534720152 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QD0000X |
Clinic/Center Specialization: Dental |
DE00008641 | WA | Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Tacoma Dental and Implant Center PS | Doing Business As Name - Organization |
Entity Type | Entity Name | Entity Address |
---|---|---|
Washington State Corporations | TACOMA DENTAL AND IMPLANT CENTER PS | 4704 S Oakes Street #103, Tacoma, WA 98409 |
Street Address |
4704 SOUTH OAKES ST #103 |
City | TACOMA |
State | WA |
Zip Code | 98409 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053942805 | Terah Jo Barker | Behavior Technician | 4301 South Pine St., Suite 505, Tacoma, WA 98409 | 2020-01-30 |
1427526797 | Carrissa Bentley | Social Worker | 3901 S. Fife Street, Tacoma, WA 98409 | 2018-11-05 |
1396255972 | Julie Ann Sunada | Nurse Practitioner | 2505 S 38th St Ste 109, Tacoma, WA 98409 | 2017-10-09 |
1306389820 | Laura Town | Chiropractor | 3640 S Cedar St, Ste P, Tacoma, WA 98409 | 2016-12-01 |
1114476082 | Chelsea Marie Jensen | Massage Therapist | 701 Commerce Street Apartment 307, Tacoma, WA 98409 | 2016-10-03 |
1831574730 | Artika Naidu | Optometrist | 4502 South Steele #700, Located Inside Macy's Lenscrafters, Tacoma, WA 98409 | 2015-07-22 |
1457795957 | Ana Amparo Penas Vasquez | Clinical Nurse Specialist | 2505 South 38th St, Bldg A Suite 109, Tacoma, WA 98409 | 2013-04-26 |
1033452156 | Richard William Solitaire | Counselor | 4301 S. Pine St., 30-19, Tacoma, WA 98409 | 2013-03-27 |
1790042810 | Tara Kerin Garland | Counselor | 5921 S. Verde St., Tacoma, WA 98409 | 2012-04-13 |
1942591532 | Kaiser Foundation Health Plan of Washington | Clinic/Center | 5821 S Sprague Court, Tacoma, WA 98409 | 2011-04-29 |
Find all providers in zip 98409 |
Taxonomy Code | 261QD0000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Dental |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558926055 | Doctors Crane Cramer Pllc | Clinic/Center | 2215 N 30th St Ste B, Tacoma, WA 98403-3350 | 2019-05-09 |
1538545637 | Roozbeh Khosravi | Clinic/Center | 3555 Mckinley Ave, Tacoma, WA 98404-2162 | 2015-07-31 |
1770809832 | Everlast Family Dental Clinic | Clinic/Center | 1212 S 11th St Ste 47, Tacoma, WA 98405-4021 | 2010-04-14 |
1528212354 | Alan F. Altman, Dds, PC | Clinic/Center | 2302 S Union Ave Ste A6, Tacoma, WA 98405-1332 | 2008-11-06 |
1609099464 | Mostafa Norooz, D.d.s., P.s. | Clinic/Center | 314 M. L. King Way, Suite #206, Tacoma, WA 98405 | 2007-04-10 |
1750409827 | Olympic Dental & Denture Center,llc | Clinic/Center | 3720 6th Ave Ste A, Tacoma, WA 98406-4938 | 2007-03-27 |
1578503157 | John C. Winskill, D.d.s., P.s. | Clinic/Center | 2215 N 30th St, Suit #104, Tacoma, WA 98403 | 2006-06-08 |
1033723366 | Community Health Care | Clinic/Center | 3811 E Arlington Dr Rm 117, Tacoma, WA 98404-4613 | 2020-09-03 |
1417506049 | David R Hannula Dds Ps | Clinic/Center | 4146 6th Ave, Tacoma, WA 98406-4013 | 2019-09-06 |
1366959009 | Jed De La Paz LLC | Clinic/Center | 15 Oregon Ave, Tacoma, WA 98409-7461 | 2018-01-03 |
Find all providers in TACOMA |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.