Individual provider Active NPI

Tar C Aw, D.D.S.

  • General Practice Dentistry
  • Seattle, WA
National Provider Identifier
1689728065
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00008955 Issued in WA
Practice address
1959 NE Pacific St
Uw D770 HSB, Box 357456
Seattle, WA 98195-7456
Phone
(206) 543-5948
Fax
(206) 543-7783
NPI assigned
Jan 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 DE00008955 WA Primary

Addresses

Primary practice location

1959 NE Pacific St
Uw D770 HSB, Box 357456
Seattle, WA 98195-7456

Mailing address

17120 13TH Ave NW
Shoreline, WA 98177-3835
Phone (206) 542-2746

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

State licenses

LicenseStateTypeSpecialty
DE00008955WAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689728065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17120 13TH AVE NW",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981773835",
            "telephone_number": "206-542-2746",
            "fax_number": "206-543-7783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "address_2": "UW D770 HSB, BOX 357456",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981957456",
            "telephone_number": "206-543-5948",
            "fax_number": "206-543-7783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AW",
        "first_name": "TAR",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00008955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.