Active NPI
Serena Tham, D.M.D.
- General Practice Dentistry
- Bellevue, WA
National Provider Identifier
1073641577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 61237298
- Practice address
- 1050 140TH Ave NE
Bellevue, WA 98005-2972 - Phone
- (425) 373-3000
- NPI assigned
- Feb 28, 2007
- Last updated
- Oct 25, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 52120 | CA | |
| General Practice Dentistry | 1223G0001X | 61237298 | WA | Primary |
Addresses
Primary practice location
1050 140TH Ave NE
Bellevue, WA 98005-2972
Mailing address
1050 140TH Ave NE
Bellevue, WA 98005-2972
Phone (425) 373-3000
Other practice location 1
7025 N Maple Ave
#101
Fresno, CA 93720-8006
Phone (559) 322-4689
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 |
|---|---|---|---|
| 61237298 | WA | MD | General Practice Dentistry |
| 52120 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Serena Tham DMD PLLC | Current | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666656000000",
"number": "1073641577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 140TH AVE NE",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980052972",
"telephone_number": "425-373-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 140TH AVE NE",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980052972",
"telephone_number": "425-373-3000"
}
],
"practiceLocations": [
{
"address_1": "7025 N Maple Ave",
"address_2": "#101",
"address_purpose": "LOCATION",
"city": "Fresno",
"state": "CA",
"postal_code": "937208006",
"country_code": "US",
"telephone_number": "559-322-4689",
"fax_number": "559-322-4691",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THAM",
"first_name": "SERENA",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-28",
"last_updated": "2022-10-25",
"certification_date": "2022-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "52120",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "61237298",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.