Active NPI
Ryan Tam, DDS
- Dentist
- Mercer Island, WA
National Provider Identifier
1740807577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0000000000
- Practice address
- 2825 80TH Ave SE Ste 3
Mercer Island, WA 98040-2977 - Phone
- (206) 232-3600
- NPI assigned
- Jun 27, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0000000000 | WA | Primary |
Addresses
Primary practice location
2825 80TH Ave SE Ste 3
Mercer Island, WA 98040-2977
Mailing address
9741 S 222ND St
Kent, WA 98031-2410
Phone (206) 913-7392
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0000000000 | WA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Goichi Shiotsu DDS P S | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Mercer Island, WA
- NPI 1649724220
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593216000000",
"number": "1740807577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9741 S 222ND ST",
"city": "KENT",
"state": "WA",
"postal_code": "980312410",
"telephone_number": "206-913-7392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2825 80TH AVE SE STE 3",
"city": "MERCER ISLAND",
"state": "WA",
"postal_code": "980402977",
"telephone_number": "206-232-3600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAM",
"first_name": "RYAN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-06-27",
"last_updated": "2020-06-27",
"certification_date": "2020-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "0000000000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mercer Island, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.