Individual provider Active NPI

Amanda M Tinkle, DMD

  • General Practice Dentistry
  • Vancouver, WA
National Provider Identifier
1134420581
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
60266590 Issued in WA
Practice address
117 E 39TH St
Vancouver, WA 98663-2229
Phone
(360) 694-7931
Fax
(360) 694-0722
NPI assigned
Nov 16, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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 60266590 WA Primary

Addresses

Primary practice location

117 E 39TH St
Vancouver, WA 98663-2229

Mailing address

117 E 39TH St
Vancouver, WA 98663-2229
Phone (360) 694-7931

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
60266590WAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1134420581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 E 39TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632229",
            "telephone_number": "360-694-7931",
            "fax_number": "360-694-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E 39TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632229",
            "telephone_number": "360-694-7931",
            "fax_number": "360-694-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINKLE",
        "first_name": "AMANDA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-16",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "60266590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.