Andrew J Tellington, D.M.D

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DE60426234 Issued in WA

Practice address

2040 Mitchell Rd SE
Port Orchard, WA 98366-4401

Phone

(360) 895-8841

Fax

(360) 895-9350

NPI assigned

Aug 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 6, 2021 through Apr 6, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Andrew J. Tellington DMD, P.C.

  dba West Sound Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Bainbridge Island, WA
  • NPI 1427997105
  NPD Authorized official
• Andrew J. Tellington DMD, P.C.

  dba West Sound Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Port Orchard, WA
  • NPI 1942802301
  NPD Authorized official
• The Greenawalt Dhaliwal LLP

  dba Kitsap OMS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Poulsbo, WA
  • NPI 1467655548

  Oral and Maxillofacial Surgery

  NPD (past)
• Tracy R. Johnson, DDS, PS

  • Oral and Maxillofacial Surgery (Dentist)
  • Port Orchard, WA
  • NPI 1376718957
  NPD (past)
• Willamette Dental Group, P.C.

  • Dentist
  • Lacey, WA
  • NPI 1679409684
  NPD (past)
• Willamette Dental Group, P.C.

  • Dentist
  • Tacoma, WA
  • NPI 1881520880
  NPD (past)

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1174717524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10855 SILVERDALE WAY NW UNIT 1460",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983839827",
            "telephone_number": "360-895-8841",
            "fax_number": "360-895-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 MITCHELL RD SE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983664401",
            "telephone_number": "360-895-8841",
            "fax_number": "360-895-9350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34800 Bob Wilson Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921341098",
            "country_code": "US",
            "telephone_number": "619-532-8600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "727 Ericksen Ave NE Ste 2",
            "address_purpose": "LOCATION",
            "city": "Bainbridge Island",
            "state": "WA",
            "postal_code": "981101882",
            "country_code": "US",
            "telephone_number": "206-842-8135",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3866 S 74th St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984099908",
            "country_code": "US",
            "telephone_number": "855-433-6825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4550 3rd Ave SE",
            "address_purpose": "LOCATION",
            "city": "Lacey",
            "state": "WA",
            "postal_code": "985031033",
            "country_code": "US",
            "telephone_number": "855-433-6825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3773 Martin Way E Ste C105",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985065048",
            "country_code": "US",
            "telephone_number": "855-433-6825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TELLINGTON",
        "first_name": "ANDREW",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-29",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE60426234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Port Orchard, WA
• Providers in Port Orchard, WA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.