Jared Doman, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DE00011054 Issued in WA

Practice address

620 Triangle Shopping Ctr Ste 660
Longview, WA 98632-4690

Phone

(360) 803-8003

Fax

(360) 283-0864

NPI assigned

Apr 29, 2008

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Three Rivers Dental LLC

  • Dental Clinic/Center
  • Longview, WA
  • NPI 1932805363
  NPD Authorized official

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1700051760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 TRIANGLE SHOPPING CTR STE 660",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 TRIANGLE SHOPPING CTR STE 660",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324690",
            "telephone_number": "360-803-8003",
            "fax_number": "360-283-0864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMAN",
        "first_name": "JARED",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-29",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00011054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Matthew Dodge, DMD
• Julie Doherty
• Lisa L Doherty, M.D.
• Lucas Clair Dolan
• Jordyn Dole, MA, LMHCA
• Hilary Gwen Don'T Mix, AAC, SUDPT
• Donald G. Echols DDS
• Jodi A Donaldson, LICSW
• Hannah J Donayri, BA, C-AAC
• Jessica Doughty, DPT, PT

• Dentist in Longview, WA
• Providers in Longview, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; 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.