Thomas Vincent Phung Duffy

Primary specialty

DentistTaxonomy code 122300000X

License

DE60477489 Issued in WA

Practice address

717 W. Railroad Ave.
Shelton, WA 98584

Phone

(360) 426-1664

NPI assigned

Oct 1, 2014

Last updated

Oct 1, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thomas V.P. Duffy, DDS, PLLC

  dba Peninsula Family Dentistry

  • Dental Clinic/Center
  • Gig Harbor, WA
  • NPI 1265379986
  NPD Authorized official

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1639572977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 W. RAILROAD AVE.",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "98584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 W. RAILROAD AVE.",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "98584",
            "telephone_number": "360-426-1664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFFY",
        "first_name": "THOMAS",
        "middle_name": "VINCENT PHUNG",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-01",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60477489",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60477489",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Marie Distler
• Laura Dixon
• Donald R. Miller, MD
• Brenda Dorsey, MSW, LMHC
• Marsha Lynn Dougherty, MS, PT
• Dacia Aloha Dunbar
• Deborah Renee Duncan-Sargent, LMP
• Cynthia Jean Dyrnes, LMHC
• Clayton Eaton
• Nicole Eddins, PHARM D

• Dentist in Shelton, WA
• Providers in Shelton, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; 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.