Darrin Mitsuo Tamanaha, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60264887 Issued in WA

Practice address

1450 First Avenue SW
Quincy, WA 98848

Phone

(509) 765-0674

Fax

(509) 765-6591

NPI assigned

Sep 30, 2010

Last updated

May 20, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1285804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400544000000",
    "number": "1336458967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 FIRST AVENUE SW",
            "city": "QUINCY",
            "state": "WA",
            "postal_code": "98848",
            "telephone_number": "509-765-0674",
            "fax_number": "509-765-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMANAHA",
        "first_name": "DARRIN",
        "middle_name": "MITSUO",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-30",
        "last_updated": "2014-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ND",
            "license": "2092",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9275",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60264887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Sherberg, APRN
• Shopko Stores Operating Co LLC (Shopko Pharmacy 794)
• Lynne M Slouber, LMHC, NCC, M.ED.
• Eric David Soule, DC
• Melissa Suarez
• Julie Ann Thomas, APRN
• Thrifty Payless Inc (Rite Aid Pharmacy 06474)
• Total Renal Care Inc (Monument Hill Dialysis)
• David Tran
• Robin Trost, ARNP, FNP-BC

• General Practice Dentistry in Quincy, WA
• Providers in Quincy, 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 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.