Active NPI
Jill Noelle Tetrick, DDS
- General Practice Dentistry
- Bellingham, WA
National Provider Identifier
1003128208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 60215480
- Practice address
- 3628 Meridian St Ste 1C
Bellingham, WA 98225-1735 - Phone
- (360) 734-4374
- Fax
- (360) 715-9196
- NPI assigned
- Jul 6, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 60215480 | WA | Primary |
Addresses
Primary practice location
3628 Meridian St Ste 1C
Bellingham, WA 98225-1735
Mailing address
3628 Meridian St Ste 1C
Bellingham, WA 98225-1735
Phone (360) 734-4374
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60215480 | WA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bellingham Family Dentistry | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dental Clinic/Center
- Bellingham, WA
- NPI 1114261187
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510790400000",
"number": "1003128208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3628 MERIDIAN ST STE 1C",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982251735",
"telephone_number": "360-734-4374",
"fax_number": "360-715-9196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3628 MERIDIAN ST STE 1C",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982251735",
"telephone_number": "360-734-4374",
"fax_number": "360-715-9196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TETRICK",
"first_name": "JILL",
"middle_name": "NOELLE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-06",
"last_updated": "2017-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "60215480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bellingham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.