NPIMap

Organization Active NPI

Tracy H Takenaka DDS MSD PS

  • Dental Clinic/Center
  • Dupont, WA
National Provider Identifier
1144567504
Registry record updated Jan 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DE60023910 Issued in WA
Legal business name
TRACY H TAKENAKA DDS MSD PS
Practice address
1200 Station Dr Ste 180
Dupont, WA 98327-9804
Phone
(253) 964-0150
Fax
(253) 964-9830
NPI assigned
Jan 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2013

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

Authorized official

Name
Tracy H Takenaka, DDS
Title
Owner/Dentist
Phone
(253) 964-0150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DE60023910 WA Primary

Addresses

Primary practice location

1200 Station Dr Ste 180
Dupont, WA 98327-9804

Mailing address

1200 Station Dr Ste 180
Dupont, WA 98327-9804
Phone (253) 964-0150

Other names 1

  • Children's Dentistry of Dupont Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1357257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357257600000",
    "number": "1144567504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 STATION DR STE 180",
            "city": "DUPONT",
            "state": "WA",
            "postal_code": "983279804",
            "telephone_number": "253-964-0150",
            "fax_number": "253-964-9830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 STATION DR STE 180",
            "city": "DUPONT",
            "state": "WA",
            "postal_code": "983279804",
            "telephone_number": "253-964-0150",
            "fax_number": "253-964-9830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY H TAKENAKA DDS MSD PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-04",
        "last_updated": "2013-01-04",
        "status": "A",
        "authorized_official_last_name": "TAKENAKA",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "253-964-0150",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "DE60023910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Dentistry of Dupont",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dupont, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; 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.