Active NPI
Renee Tai, D.D.S.
- Dentist
- Port Angeles, WA
National Provider Identifier
1134579824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE60487996
- Practice address
- 1417 E Front St
Port Angeles, WA 98362-4618 - Phone
- (360) 457-5437
- NPI assigned
- Jun 14, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE60487996 | WA | Primary |
Addresses
Primary practice location
1417 E Front St
Port Angeles, WA 98362-4618
Mailing address
1520 Weathervane Dr
Fircrest, WA 98466-5715
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
| License | State | Type | Specialty |
|---|---|---|---|
| DE60487996 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711324800000",
"number": "1134579824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1520 WEATHERVANE DR",
"city": "FIRCREST",
"state": "WA",
"postal_code": "984665715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1417 E FRONT ST",
"city": "PORT ANGELES",
"state": "WA",
"postal_code": "983624618",
"telephone_number": "360-457-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAI",
"first_name": "RENEE",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-14",
"last_updated": "2024-03-25",
"certification_date": "2024-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE60487996",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Angeles, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.