Individual provider Active NPI

Alma Mocon Tendencia, RDA

  • Dental Assistant
  • Everett, WA
National Provider Identifier
1710615414
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
License
D160052314 Issued in WA
Practice address
10812 19TH Ave SE
Everett, WA 98208-5153
Phone
(425) 338-5414
Fax
(425) 338-5744
NPI assigned
Aug 10, 2022
Last updated
Aug 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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 D160052314 WA Primary

Addresses

Primary practice location

10812 19TH Ave SE
Everett, WA 98208-5153

Mailing address

10812 19TH Ave SE
Everett, WA 98208-5153
Phone (425) 338-5414

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
D160052314WAMDDental Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South Everett Orthodontics LLC Dental Assistant CurrentSince Sep 1, 2022 Accepting new patients
Silverlake Orthodontics CurrentSince Aug 14, 2022 Accepting new patients

Locations

10812 19th Ave SE
Everett, WA 98208
Phone (425) 338-5414

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1710615414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10812 19TH AVE SE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982085153",
            "telephone_number": "425-338-5414",
            "fax_number": "425-338-5744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10812 19TH AVE SE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982085153",
            "telephone_number": "425-338-5414",
            "fax_number": "425-338-5744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENDENCIA",
        "first_name": "ALMA",
        "middle_name": "MOCON",
        "credential": "RDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-10",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "WA",
            "license": "D160052314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.