Christian Rene Iturriaga, DPD

Primary specialty

DenturistTaxonomy code 122400000X

License

DN00000423 Issued in WA

Practice address

5219 W Clearwater Ave Ste 16
Kennewick, WA 99336-1980

Phone

(509) 374-1660

Fax

(509) 374-9374

NPI assigned

Jun 10, 2007

Last updated

Jul 28, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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": "1181433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1417150038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5219 W CLEARWATER AVE STE 16",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993361980",
            "telephone_number": "509-374-1660",
            "fax_number": "509-374-9374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5219 W CLEARWATER AVE STE 16",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993361980",
            "telephone_number": "509-374-1660",
            "fax_number": "509-374-9374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5735 N Division St",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992081216",
            "country_code": "US",
            "telephone_number": "509-934-1159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ITURRIAGA",
        "first_name": "CHRISTIAN",
        "middle_name": "RENE",
        "credential": "DPD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-10",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "",
            "desc": "Denturist",
            "state": "WA",
            "license": "DN00000423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1091700",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5049226",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Denturist in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Denturist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; 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.