Individual provider Active NPI

Tri Thuc To, D.D.S

  • Public Health Dentistry
  • Seattle, WA
National Provider Identifier
1528132305
Registry record updated Oct 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
DE00010383 Issued in WA
Practice address
2124 4TH Ave
Seattle, WA 98121-2308
Phone
(206) 296-3109
Fax
(206) 296-0184
NPI assigned
Nov 20, 2006
Last updated
Oct 14, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X DE00010383 WA Primary

Addresses

Primary practice location

2124 4TH Ave
Seattle, WA 98121-2308

Mailing address

1801 Kitsap PL NE
Renton, WA 98059-6045
Phone (425) 291-7268

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
I20170208000434 WA Order and Referring Only - DentistPractitioner - Dentist 1153604673

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE00010383WAMDPublic Health Dentist

Interoperability endpoints

  • Direct secure messaging: tto178943@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413244800000",
    "number": "1528132305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 KITSAP PL NE",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980596045",
            "telephone_number": "425-291-7268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 4TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981212308",
            "telephone_number": "206-296-3109",
            "fax_number": "206-296-0184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TO",
        "first_name": "TRI",
        "middle_name": "THUC",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2014-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "WA",
            "license": "DE00010383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.