Individual provider Active NPI

My Anh Doan, DMD

  • General Practice Dentistry
  • Federal Way, WA
National Provider Identifier
1366730038
Registry record updated Jul 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE 00008296 Issued in WA
Practice address
30620 Pacific Hwy S
111
Federal Way, WA 98003-4888
Phone
(253) 946-3895
Fax
(253) 946-8596
NPI assigned
Jul 15, 2011
Last updated
Jul 15, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE 00008296 WA Primary

Addresses

Primary practice location

30620 Pacific Hwy S
111
Federal Way, WA 98003-4888

Mailing address

30620 Pacific Hwy S
111
Federal Way, WA 98003-4888
Phone (253) 946-3895

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

State licenses

LicenseStateTypeSpecialty
DE 00008296WAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1310688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310688000000",
    "number": "1366730038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30620 PACIFIC HWY S",
            "address_2": "111",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980034888",
            "telephone_number": "253-946-3895",
            "fax_number": "253-946-8596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30620 PACIFIC HWY S",
            "address_2": "111",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980034888",
            "telephone_number": "253-946-3895",
            "fax_number": "253-946-8596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOAN",
        "first_name": "MY ANH",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-15",
        "last_updated": "2011-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE 00008296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2011; 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.