Stephanie Herrala, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

60757615 Issued in WA

Practice address

Okubo Dental Clinic 11582 C St
JBLM, WA 98466

Phone

(253) 966-1991

NPI assigned

Aug 16, 2017

Last updated

Aug 16, 2017By the provider in NPPES

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

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": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502841600000",
    "number": "1386160984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 78TH AVENUE CT W APT H204",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984663283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "OKUBO DENTAL CLINIC 11582 C ST",
            "city": "JBLM",
            "state": "WA",
            "postal_code": "98466",
            "telephone_number": "253-966-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRALA",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-16",
        "last_updated": "2017-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "60757615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Richard Gray, PA-C
• Philip Griffith, LCSW
• Lindsey Nicole Hancock, LCSW
• Summer M Harris
• Katarzyna Hefflefinger, DPT
• Pamela Jernigan, RDH
• Angela Maria Lewis
• Kevin Lok, MD
• Sammy Martinez, 164W00000X
• Jane K McIntosh

• Dentist in JBLM, WA
• Providers in JBLM, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2017; 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.