Kenneth Charles Dahlin, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00001353 Issued in WA

Practice address

4502 S Steele St
Ste 304B
Tacoma, WA 98409-7242

Phone

(253) 475-3937

Fax

(253) 473-4278

NPI assigned

Jun 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Kenneth C. Dahlin, O.D., PLLC

  • Optometrist
  • Tacoma, WA
  • NPI 1407803356
  NPD (past) Authorized official

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356480000000",
    "number": "1699770461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 S STEELE ST",
            "address_2": "STE 304B",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097258",
            "telephone_number": "253-475-3937",
            "fax_number": "253-473-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 S STEELE ST",
            "address_2": "STE 304B",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097242",
            "telephone_number": "253-475-3937",
            "fax_number": "253-473-4278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLIN",
        "first_name": "KENNETH",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2012-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2029411",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryan R Dahlberg
• Amber Jean Dahle
• Ashley Lorraine Dahlgren
• Emily Dahlgren
• Aaron C Dahlin, DO
• Bailey Dahms
• Christopher Dailey, DPT
• Kathryn Dailey, OD
• Liliya V Dailey, LMP
• Jeffrey L Daily

• Optometrist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2012; 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.