Individual provider Active NPI

Crystal Vargas, DDS

  • General Practice Dentistry
  • Tacoma, WA
National Provider Identifier
1689009060
Registry record updated Sep 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
60393627 Issued in WA
Practice address
3866 S 74TH St Ste 200
Tacoma, WA 98409-9908
Phone
(855) 433-6825
NPI assigned
Sep 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2016

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 60393627 WA Primary

Addresses

Primary practice location

3866 S 74TH St Ste 200
Tacoma, WA 98409-9908

Mailing address

6950 NE Campus Way
Hillsboro, OR 97124-5611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150605001604 WA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6002137767

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60393627WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Willamette Dental Group, P.C. Past Accepting new patients

Organizations & group practices 1

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": "1378252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473552000000",
    "number": "1689009060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6950 NE CAMPUS WAY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3866 S 74TH ST STE 200",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984099908",
            "telephone_number": "855-433-6825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "CRYSTAL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-04",
        "last_updated": "2016-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "60393627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.