Individual provider Active NPI

Tiah Christine Eskildsen

  • Dental Assistant
  • Walla Walla, WA
National Provider Identifier
1649786484
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
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, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
100439516WAMedicaidWA

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.

Verify at the official NPI Registry.