Individual provider Active NPI

Erika Kathleen Coombs, D.D.S.

  • Dentist
  • Traverse City, MI
National Provider Identifier
1649626672
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901601227 Issued in MI
Practice address
3375 S Airport Rd W
Traverse City, MI 49684-7929
Phone
(231) 486-0555
NPI assigned
May 9, 2016
Last updated
Jul 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE60751092 WA
Dentist 122300000X 2901601227 MI Primary

Addresses

Primary practice location

3375 S Airport Rd W
Traverse City, MI 49684-7929

Mailing address

3375 S Airport Rd W
Traverse City, MI 49684-7929

Other practice location 1

6505 216th St SW Ste 200
Mountlake Terrace, WA 98043-6026
Phone (855) 433-6825

Other practice location 2

6101 200th St SW Ste 201
Lynnwood, WA 98036-6077
Phone (425) 670-0814

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
2901601227MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Willamette Dental Group, P.C. Dentist PastSince Nov 1, 2020 Accepting new patients
Tawfiq Alkilani DDS PLLC PastSince Jul 31, 2022 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1649626672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 S AIRPORT RD W",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3375 S AIRPORT RD W",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847929",
            "telephone_number": "231-486-0555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6505 216th St SW Ste 200",
            "address_purpose": "LOCATION",
            "city": "Mountlake Terrace",
            "state": "WA",
            "postal_code": "980436026",
            "country_code": "US",
            "telephone_number": "855-433-6825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6101 200th St SW Ste 201",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980366077",
            "country_code": "US",
            "telephone_number": "425-670-0814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOMBS",
        "first_name": "ERIKA",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-09",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60751092",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901601227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; 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.