Thalia-Rae Criddle PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

THALIA-RAE CRIDDLE PLLC

Practice address

1625 SE 192ND Ave Ste 205
Camas, WA 98607-7441

Phone

(617) 762-6661

NPI assigned

Sep 7, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Thalia-Rae Criddle, DMD

Title

Owner

Phone

(617) 762-6661

Specialties & licenses 1

Addresses

Other names 1

• Criddle Concierge Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thalia-Rae Perryman, DMD

  • Dentist
  • Camas, WA
  • NPI 1881075182
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714608000000",
    "number": "1063181709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5781 SW CLAY CT",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972211438",
            "telephone_number": "617-762-6661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 SE 192ND AVE STE 205",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986077441",
            "telephone_number": "617-762-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THALIA-RAE CRIDDLE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-07",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A",
        "authorized_official_last_name": "CRIDDLE",
        "authorized_official_first_name": "THALIA-RAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-762-6661",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Criddle Concierge",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Criddle Concierge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Timothy Noel Tanada, D.M.D.
• Bonnie Lee Taylor, LMP
• Sandra Weis Taylor, M.S., CCC-SLP
• Michael D Teater, PT, DPT, OCS
• Terrain Wellness LLC
• The 13TH Street House LLC
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• The Catalyst Center for Psychological Wellness
• The Collective Wellbeing Psychological Center PLLC
• The Healing Hands LMT LLC

• Dental Clinic/Center in Camas, WA
• Providers in Camas, WA by specialty
• Dental Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.