Active NPI
Lateefah Tyme Washington, DMD, MS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Grand Prairie, TX
National Provider Identifier
1265768154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DN013984
- Practice address
- 2630 S Carrier Pkwy Ste a
Grand Prairie, TX 75052-5000 - Phone
- (917) 846-5216
- NPI assigned
- Oct 27, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DN013984 | GA | Primary |
Addresses
Primary practice location
2630 S Carrier Pkwy Ste a
Grand Prairie, TX 75052-5000
Mailing address
2630 S Carrier Pkwy Ste a
Grand Prairie, TX 75052-5000
Phone (917) 846-5216
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN013984 | GA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373932800000",
"number": "1265768154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2630 S CARRIER PKWY STE A",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750525000",
"telephone_number": "917-846-5216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2630 S CARRIER PKWY STE A",
"city": "GRAND PRAIRIE",
"state": "TX",
"postal_code": "750525000",
"telephone_number": "917-846-5216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASHINGTON",
"first_name": "LATEEFAH",
"middle_name": "TYME",
"credential": "DMD, MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-27",
"last_updated": "2013-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "GA",
"license": "DN013984",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Prairie, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.