Active NPI
Breinn Ashley Bertrand, DDS
- General Practice Dentistry
- Puyallup, WA
National Provider Identifier
1083269682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 60970002
- Practice address
- 13613 Meridian E Ste 180
Puyallup, WA 98373-3664 - Phone
- (253) 845-3000
- NPI assigned
- Aug 9, 2019
- 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 | 60970002 | WA | Primary |
Addresses
Primary practice location
13613 Meridian E Ste 180
Puyallup, WA 98373-3664
Mailing address
1911 N 46TH St Apt 306
Seattle, WA 98103-6860
Phone (253) 579-4103
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 |
|---|---|---|---|
| 60970002 | WA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| H.S. Walia DDS Fagd & Kunal Walia DDS PS | General Practice | 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.
-
- General Practice Dentistry
- Puyallup, WA
- NPI 1700725611
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565308800000",
"number": "1083269682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1911 N 46TH ST APT 306",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981036860",
"telephone_number": "253-579-4103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13613 MERIDIAN E STE 180",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983733664",
"telephone_number": "253-845-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERTRAND",
"first_name": "BREINN",
"middle_name": "ASHLEY",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-09",
"last_updated": "2019-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "60970002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.