Carrie Ann Tatum, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00009098 Issued in WA

Practice address

605 S Coolidge St
Moses Lake, WA 98837-1893

Phone

(509) 765-0674

Fax

(509) 765-6591

NPI assigned

Dec 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368403200000",
    "number": "1285793398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1571 FAIRWAY DR NE",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988379161",
            "telephone_number": "509-766-7294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S COOLIDGE ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371893",
            "telephone_number": "509-765-0674",
            "fax_number": "509-765-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "CARRIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2013-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00009098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5040696",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT  LABOR & INDUSTRIES",
            "identifier": "181185",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alberto Tafoya, DC
• Craig F Talbot, M.D.
• Dennis Talbot, PA-C
• Haley Tanke, LL61087644
• Kierstin T Tate, LCSW
• Marquez Taylor, LMT
• Olivea Raine Taylor, PA-C
• Cindy Sue Teeter, RN- BSN
• Lillie Beatrice Terrell-McDonald
• Shannon Terry, ARNP

• General Practice Dentistry in Moses Lake, WA
• Providers in Moses Lake, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.