Individual provider Active NPI

Tristan J Stone, DDS

  • Public Health Dentistry
  • Bellingham, WA
National Provider Identifier
1134478795
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
DE60606151 Issued in WA
Practice address
1420 King St Ste B
Bellingham, WA 98229-6264
Phone
(360) 671-4552
NPI assigned
Aug 29, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X DE60606151 WA Primary

Addresses

Primary practice location

1420 King St Ste B
Bellingham, WA 98229-6264

Mailing address

2400 Lisa LN
Bellingham, WA 98229-2318
Phone (425) 761-9195

Other practice location 1

1861 Main St
Sneedville, TN 37869-3645
Phone (423) 733-2131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20160204001083 TN Order and Referring Only - DentistPractitioner - Dentist 4981908357

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE60606151WAMDPublic Health Dentist

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1134478795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 LISA LN",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982292318",
            "telephone_number": "425-761-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 KING ST STE B",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982296264",
            "telephone_number": "360-671-4552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1861 Main St",
            "address_purpose": "LOCATION",
            "city": "Sneedville",
            "state": "TN",
            "postal_code": "378693645",
            "country_code": "US",
            "telephone_number": "423-733-2131",
            "fax_number": "423-733-1055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STONE",
        "first_name": "TRISTAN",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-29",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "WA",
            "license": "DE60606151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.