NPIMap

Organization Active NPI

Kyle Tanaka DDS PLLC

Doing business as Alderwood Progressive Dentistry

  • Dentist
  • Lynnwood, WA
National Provider Identifier
1326354226
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE00010994 Issued in WA
Legal business name
KYLE TANAKA DDS PLLC
Doing business as
Alderwood Progressive Dentistry
Practice address
19320 40TH Ave W
Suite a
Lynnwood, WA 98036-4602
Phone
(425) 776-2126
Fax
(425) 670-8177
NPI assigned
Aug 30, 2010
Last updated
Oct 16, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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

Authorized official

Name
Dr. Kyle Tanaka, DDSNPI 1508946567
Title
President
Phone
(425) 776-2126

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DE00010994 WA Primary

Addresses

Primary practice location

19320 40TH Ave W
Suite a
Lynnwood, WA 98036-4602

Mailing address

19320 40TH Ave W
Suite a
Lynnwood, WA 98036-4602
Phone (425) 776-2126

Other names 1

  • Alderwood Progressive Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

19320 40th Ave W
Ste A
Lynnwood, WA 98036
Phone (425) 776-2126

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350345600000",
    "number": "1326354226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19320 40TH AVE W",
            "address_2": "SUITE A",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364602",
            "telephone_number": "425-776-2126",
            "fax_number": "425-670-8177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19320 40TH AVE W",
            "address_2": "SUITE A",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364602",
            "telephone_number": "425-776-2126",
            "fax_number": "425-670-8177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYLE TANAKA DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-30",
        "last_updated": "2012-10-16",
        "status": "A",
        "authorized_official_last_name": "TANAKA",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-776-2126",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00010994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alderwood Progressive Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; 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.