Individual provider Active NPI

Marvin Edward Swainson, DDS

  • General Practice Dentistry
  • Yakima, WA
National Provider Identifier
1629136890
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3607 Issued in WA
Practice address
1417 Lakeside CT
Yakima, WA 98902-7354
Phone
(509) 494-0121
Fax
(509) 494-0171
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 3607 WA Primary

Addresses

Primary practice location

1417 Lakeside CT
Yakima, WA 98902-7354

Mailing address

1417 Lakeside CT
Yakima, WA 98902-7354
Phone (509) 494-0121

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3607WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Steven T. Kitts DDS PLLC Past Accepting new patients
Karen J Tritinger-Young DMD PLLC General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629136890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 LAKESIDE CT",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027354",
            "telephone_number": "509-494-0121",
            "fax_number": "509-494-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 LAKESIDE CT",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027354",
            "telephone_number": "509-494-0121",
            "fax_number": "509-494-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAINSON",
        "first_name": "MARVIN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "3607",
            "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 Jul 8, 2007; 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.