Individual provider Active NPI

Christopher Paul Trammell, D.D.S.

  • General Practice Dentistry
  • Yakima, WA
National Provider Identifier
1619986445
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00008775 Issued in WA
Practice address
1006 S. 64TH Ave.
Suite 130
Yakima, WA 98908
Phone
(509) 965-0080
Fax
(509) 965-7328
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE00008775 WA Primary

Addresses

Primary practice location

1006 S. 64TH Ave.
Suite 130
Yakima, WA 98908

Mailing address

1003 S. 64TH Ave.
Suite 130
Yakima, WA 98908
Phone (509) 469-2496

Other identifiers 1

IdentifierTypeStateIssuer
5034590MedicaidWA

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
I20170208000374 WA Order and Referring Only - DentistPractitioner - Dentist 7719260231

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE00008775WAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1619986445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 S. 64TH AVE.",
            "address_2": "SUITE 130",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "98908",
            "telephone_number": "509-469-2496",
            "fax_number": "509-965-7328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 S. 64TH AVE.",
            "address_2": "SUITE 130",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "98908",
            "telephone_number": "509-965-0080",
            "fax_number": "509-965-7328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAMMELL",
        "first_name": "CHRISTOPHER",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00008775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5034590",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.