Individual provider Active NPI

Jessica K Tsukamoto, D.D.S.

  • Dentist
  • Seattle, WA
National Provider Identifier
1083990287
Registry record updated Nov 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE 60238215 Issued in WA
Practice address
902 NE 43Rd St
#607
Seattle, WA 98105-6023
Phone
(808) 393-5848
NPI assigned
Nov 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE 60238215 WA Primary

Addresses

Primary practice location

902 NE 43Rd St
#607
Seattle, WA 98105-6023

Mailing address

902 NE 43Rd St
#607
Seattle, WA 98105-6023

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

LicenseStateTypeSpecialty
DE 60238215WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1083990287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 NE 43RD ST",
            "address_2": "#607",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 NE 43RD ST",
            "address_2": "#607",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056023",
            "telephone_number": "808-393-5848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSUKAMOTO",
        "first_name": "JESSICA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-01",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE 60238215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; 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.