Individual provider Active NPI

Suzanna Ratna Tanus, D.D.S

  • General Practice Dentistry
  • Wenatchee, WA
National Provider Identifier
1275605230
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00006752 Issued in WA
Practice address
600 Orondo Ave Ste 1
Wenatchee, WA 98801-2800
Phone
(509) 662-3860
NPI assigned
Nov 14, 2006
Last updated
Feb 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE00006752 WA
General Practice Dentistry 1223G0001X DE00006752 WA Primary

Addresses

Primary practice location

600 Orondo Ave Ste 1
Wenatchee, WA 98801-2800

Mailing address

600 Orondo Ave Ste 1
Wenatchee, WA 98801-2800
Phone (509) 662-6000

Other practice location 1

105 S Apple Blossom Dr
Chelan, WA 98816-8810
Phone (509) 682-6000

Other identifiers 1

IdentifierTypeStateIssuer
2170045MedicaidWA

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
I20150323000675 WA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4587981014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE00006752WAMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: suzanna.tanus.1@10575.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1275605230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 ORONDO AVE STE 1",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012800",
            "telephone_number": "509-662-6000",
            "fax_number": "509-664-4590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ORONDO AVE STE 1",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012800",
            "telephone_number": "509-662-3860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 S Apple Blossom Dr",
            "address_purpose": "LOCATION",
            "city": "Chelan",
            "state": "WA",
            "postal_code": "988168810",
            "country_code": "US",
            "telephone_number": "509-682-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANUS",
        "first_name": "SUZANNA",
        "middle_name": "RATNA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00006752",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00006752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2170045",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

Verify at the official NPI Registry.