Active NPI
David A Tegrotenhuis, DDS
- Dentist
- Friday Harbor, WA
National Provider Identifier
1003920612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE00010112
- Practice address
- 110 Rhone St
Friday Harbor, WA 98250-8070 - Phone
- (360) 378-2888
- NPI assigned
- Aug 19, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DE00010112 | WA | Primary |
Addresses
Primary practice location
110 Rhone St
Friday Harbor, WA 98250-8070
Mailing address
110 Rhone St
Friday Harbor, WA 98250-8070
Phone (360) 378-2888
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 |
|---|---|---|---|
| DE00010112 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340755200000",
"number": "1003920612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 RHONE ST",
"city": "FRIDAY HARBOR",
"state": "WA",
"postal_code": "982508070",
"telephone_number": "360-378-2888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 RHONE ST",
"city": "FRIDAY HARBOR",
"state": "WA",
"postal_code": "982508070",
"telephone_number": "360-378-2888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEGROTENHUIS",
"first_name": "DAVID",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2012-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE00010112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Friday Harbor, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.