Individual provider Active NPI

Kevin George Dean, O.D.

  • Optometrist
  • Yakima, WA
National Provider Identifier
1487764585
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00001781 Issued in WA
Practice address
6600 W Nob Hill Blvd
Yakima, WA 98908-1976
Phone
(509) 895-5366
Fax
(509) 965-1890
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1896AT OR
Optometrist 152W00000X OD00001781 WA Primary

Addresses

Primary practice location

6600 W Nob Hill Blvd
Yakima, WA 98908-1976

Mailing address

6600 W Nob Hill Blvd
Yakima, WA 98908-1976
Phone (509) 895-5366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1896ATORMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566864000000",
    "number": "1487764585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 W NOB HILL BLVD",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989081976",
            "telephone_number": "509-895-5366",
            "fax_number": "509-965-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 W NOB HILL BLVD",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989081976",
            "telephone_number": "509-895-5366",
            "fax_number": "509-965-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "KEVIN",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2019-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1896AT",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2019; 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.