Individual provider Active NPI

Randolph J. Nartea, DDS

  • General Practice Dentistry
  • Tacoma, WA
National Provider Identifier
1093831745
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7608 Issued in WA
Practice address
1628 S Mildred St
Suite 206
Tacoma, WA 98465-1627
Phone
(253) 460-1800
Fax
(253) 460-0697
NPI assigned
Mar 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7608 WA Primary

Addresses

Primary practice location

1628 S Mildred St
Suite 206
Tacoma, WA 98465-1627

Mailing address

1628 S Mildred St
Suite 206
Tacoma, WA 98465-1627
Phone (253) 460-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160418000255 WA Order and Referring Only - DentistPractitioner - Dentist 3072811553

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7608WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lin and Nartea PLLC Current Accepting new patients
Baer and Nartea, DDS, PLLC General Practice Past Accepting new patients

Locations

5224 Wilson Ave S
Ste 101B
Seattle, WA 98118
Phone (206) 721-7880

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093831745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 S MILDRED ST",
            "address_2": "SUITE 206",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984651627",
            "telephone_number": "253-460-1800",
            "fax_number": "253-460-0697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 S MILDRED ST",
            "address_2": "SUITE 206",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984651627",
            "telephone_number": "253-460-1800",
            "fax_number": "253-460-0697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NARTEA",
        "first_name": "RANDOLPH",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "7608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.