NPIMap

Organization Active NPI

TLC Dental Inc.

  • General Practice Dentistry
  • Bremerton, WA
National Provider Identifier
1720246762
Registry record updated Dec 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00009257 Issued in WA
Legal business name
TLC DENTAL INC.
Practice address
4207 Wheaton Way
Suite C
Bremerton, WA 98310-3605
Phone
(360) 373-3487
Fax
(360) 373-3799
NPI assigned
May 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2019

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

Authorized official

Name
Hamidreza Barakhshan, D.D.S.NPI 1740349687
Title
Dentist/Owner
Phone
(360) 373-3487

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DE00009257 WA Primary

Addresses

Primary practice location

4207 Wheaton Way
Suite C
Bremerton, WA 98310-3605

Mailing address

4207 Wheaton Way
Suite C
Bremerton, WA 98310-3605
Phone (360) 373-3487

National Provider Directory

National Provider Directory

Locations

4207 Wheaton Way
Ste C
Bremerton, WA 98310
Phone (360) 373-3487

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577318400000",
    "number": "1720246762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 WHEATON WAY",
            "address_2": "SUITE C",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983103605",
            "telephone_number": "360-373-3487",
            "fax_number": "360-373-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4207 WHEATON WAY",
            "address_2": "SUITE C",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983103605",
            "telephone_number": "360-373-3487",
            "fax_number": "360-373-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC DENTAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A",
        "authorized_official_last_name": "BARAKHSHAN",
        "authorized_official_first_name": "HAMIDREZA",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "360-373-3487",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00009257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2019; 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.