Individual provider Active NPI

David N Hamilton, D.D.S.

  • Pediatric Dentistry
  • Kennewick, WA
National Provider Identifier
1235342510
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DE000113196 Issued in WA
Practice address
3911 W 27TH Ave
Suite 105
Kennewick, WA 99337-2483
Phone
(509) 585-5437
Fax
(509) 585-5438
NPI assigned
May 7, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X D9044 OR
Pediatric Dentistry 1223P0221X DE000113196 WA Primary

Addresses

Primary practice location

3911 W 27TH Ave
Suite 105
Kennewick, WA 99337-2483

Mailing address

2611 S Quillan PL
Kennewick, WA 99338-1899
Phone (509) 585-5437

Other identifiers 2

IdentifierTypeStateIssuer
DE00011196OtherWAWASHINGTON STATE DENTAL LICENSE
D9044OtherOROREGON STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20180511001655 WA Order and Referring Only - DentistPractitioner - Dentist 2062776479

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D9044ORMDPediatric Dentist
DE000113196WAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Collette & Hamilton DDS PLLC Pediatric Dentistry CurrentSince Jun 27, 2021 Accepting new patients

Locations

3911 W 27th Ave
Ste 105
Kennewick, WA 99337
Phone (509) 581-0081

3200 Duportail St
Ste 204
Richland, WA 99352
Phone (509) 946-9999

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1235342510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 S QUILLAN PL",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993381899",
            "telephone_number": "509-585-5437",
            "fax_number": "509-585-5438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 W 27TH AVE",
            "address_2": "SUITE 105",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993372483",
            "telephone_number": "509-585-5437",
            "fax_number": "509-585-5438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "DAVID",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OR",
            "license": "D9044",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE000113196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DENTAL LICENSE",
            "identifier": "DE00011196",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON STATE LICENSE",
            "identifier": "D9044",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.