Active NPI
Tiah Christine Eskildsen
- Dental Assistant
- Walla Walla, WA
National Provider Identifier
1649786484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- Practice address
- 1608 Penny LN
Walla Walla, WA 99362-4477 - Phone
- (509) 525-7030
- Fax
- (509) 280-9020
- NPI assigned
- Dec 15, 2017
- Last updated
- Mar 17, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | Primary |
Addresses
Primary practice location
1608 Penny LN
Walla Walla, WA 99362-4477
Mailing address
1614 SE Red Oak Ave
College Place, WA 99324-1791
Phone (509) 876-9746
Other practice location 1
1614 SE Red Oak Ave
College Place, WA 99324-1791
Phone (509) 876-9746
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100439516WA | Medicaid | WA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1649786484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1614 SE RED OAK AVE",
"city": "COLLEGE PLACE",
"state": "WA",
"postal_code": "993241791",
"telephone_number": "509-876-9746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1608 PENNY LN",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993624477",
"telephone_number": "509-525-7030",
"fax_number": "509-280-9020"
}
],
"practiceLocations": [
{
"address_1": "1614 SE Red Oak Ave",
"address_purpose": "LOCATION",
"city": "College Place",
"state": "WA",
"postal_code": "993241791",
"country_code": "US",
"telephone_number": "509-876-9746",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ESKILDSEN",
"first_name": "TIAH",
"middle_name": "CHRISTINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-15",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100439516WA",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Walla Walla, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.