NPIMap

Organization Active NPI

Christine M Tweedy DDS MSD PS

  • Dentist
  • Seattle, WA
National Provider Identifier
1104147057
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8359 Issued in WA
Legal business name
CHRISTINE M TWEEDY DDS MSD PS
Practice address
4520 42ND Ave SW
#24
Seattle, WA 98116-4240
Phone
(206) 937-6481
Fax
(206) 937-7043
NPI assigned
Jun 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

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

Authorized official

Name
Dr. Christine M Tweedy, DDS MSDNPI 1881794634
Title
Owner
Phone
(206) 937-6481

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 8359 WA Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 8359 WA

Addresses

Primary practice location

4520 42ND Ave SW
#24
Seattle, WA 98116-4240

Mailing address

4520 42ND Ave SW
#24
Seattle, WA 98116-4240
Phone (206) 937-6481

Other identifiers 1

IdentifierTypeStateIssuer
5031596MedicaidWA

Other names 1

  • Westside Children's Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

4520 42nd Ave SW
Ste 24
Seattle, WA 98116
Phone (206) 937-6481

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276560000000",
    "number": "1104147057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 42ND AVE SW",
            "address_2": "#24",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164240",
            "telephone_number": "206-937-6481",
            "fax_number": "206-937-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 42ND AVE SW",
            "address_2": "#24",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164240",
            "telephone_number": "206-937-6481",
            "fax_number": "206-937-7043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTINE M TWEEDY DDS MSD PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-15",
        "last_updated": "2010-06-15",
        "status": "A",
        "authorized_official_last_name": "TWEEDY",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-937-6481",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MSD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "8359",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "8359",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5031596",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westside Children's Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 15, 2010; 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.