Individual provider Active NPI

Abdullah Alkanan, BDS

  • Periodontics
  • Kennewick, WA
National Provider Identifier
1407274202
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DE61047099 Issued in WA
Practice address
2611 S Quillan PL Ste 110
Kennewick, WA 99338-1899
Phone
(509) 585-5437
NPI assigned
Mar 31, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DE61047099 WA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2611 S Quillan PL Ste 110
Kennewick, WA 99338-1899

Mailing address

PO Box 190
Toppenish, WA 98948-0190
Phone (509) 408-6298

Other practice location 1

7409 W Grandridge Blvd Ste B
Kennewick, WA 99336
Phone (312) 613-2580

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260408001560 WA Order and Referring Only - DentistPractitioner - Dentist 1355816224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE61047099WAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Abdullah Alkanan BDS PLLC Periodontics CurrentSince Oct 24, 2021 Accepting new patients
Abdullah BDS PLLC Periodontics Current Accepting new patients
Alkanan BDS PLLC Periodontics Current Accepting new patients

Locations

7409 W Grandridge Blvd
Ste B
Kennewick, WA 99336
Phone (312) 613-2580

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1407274202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "TOPPENISH",
            "state": "WA",
            "postal_code": "989480190",
            "telephone_number": "509-408-6298",
            "fax_number": "509-865-0757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2611 S QUILLAN PL STE 110",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993381899",
            "telephone_number": "509-585-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7409 W Grandridge Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Kennewick",
            "state": "WA",
            "postal_code": "99336",
            "country_code": "US",
            "telephone_number": "312-613-2580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALKANAN",
        "first_name": "ABDULLAH",
        "name_prefix": "Dr.",
        "credential": "BDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-31",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": "DE61047099",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.