NPIMap

Organization Active NPI

Tri City Dental Care, PLLC

  • Dentist
  • Kennewick, WA
National Provider Identifier
1396194338
Registry record updated Jun 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60487049 Issued in WA
Legal business name
TRI CITY DENTAL CARE, PLLC
Practice address
3711 Plaza Way
Ste 120
Kennewick, WA 99338-2718
Phone
(509) 579-0759
NPI assigned
Jun 10, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2016

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

Authorized official

Name
Dr. Antonio Lopez-Ibarra, DDSNPI 1043626674
Title
Dentist Owner
Phone
(509) 579-0759

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 DE60487049 WA Primary

Addresses

Primary practice location

3711 Plaza Way
Ste 120
Kennewick, WA 99338-2718

Mailing address

3711 Plaza Way
Ste 120
Kennewick, WA 99338-2718
Phone (509) 579-0759

National Provider Directory

National Provider Directory

Locations

3711 Plaza Way
Ste 120
Kennewick, WA 99338
Phone (509) 579-0759

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1465516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465516800000",
    "number": "1396194338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 PLAZA WAY",
            "address_2": "STE 120",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993382718",
            "telephone_number": "509-579-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 PLAZA WAY",
            "address_2": "STE 120",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993382718",
            "telephone_number": "509-579-0759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI CITY DENTAL CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-10",
        "last_updated": "2016-06-10",
        "status": "A",
        "authorized_official_last_name": "LOPEZ-IBARRA",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "509-579-0759",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60487049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; 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.