Sampada Jayant Deshpande, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

60861386 Issued in WA

Practice address

4811 Wa Tau Ga Ave NE
Tacoma, WA 98422-1799

Phone

(253) 927-9883

Fax

(253) 925-2153

NPI assigned

Aug 14, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Volland DDS PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Lake Tapps, WA
  • NPI 1962379321
  NPD (past)

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1477032035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 MILDRED ST W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984666134",
            "telephone_number": "253-566-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4811 WA TAU GA AVE NE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984221799",
            "telephone_number": "253-927-9883",
            "fax_number": "253-925-2153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESHPANDE",
        "first_name": "SAMPADA",
        "middle_name": "JAYANT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-14",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "103061",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "60861386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vivek Desai, DO
• Linda M Desantis, LMP
• Heather Deschene
• David N. Desertspring, M.D.
• Ishan Deshmukh, DO
• Desiree Turner Therapeutic Services, LLC
• Tyler Deskins, CBT
• Mesfin Gebreegziabher Desta
• Richard Derik Detheridge, M.D.
• Drew H Deutsch, MD

• All providers in Tacoma, WA
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.