Tyka L Brannan, PTDA ASSISTANT

Primary specialty

Dental AssistantTaxonomy code 126800000X

License

0764 Issued in WA

Practice address

14406 NE 20TH Ave
Vancouver, WA 98686-1448

Phone

(360) 571-3139

NPI assigned

Aug 17, 2006

Sex

Female

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760595193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 COWLITZ WAY",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "986264109",
            "telephone_number": "360-571-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14406 NE 20TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986861448",
            "telephone_number": "360-571-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANNAN",
        "first_name": "TYKA",
        "middle_name": "L",
        "credential": "PTDA ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "WA",
            "license": "0764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTDA ASSISTANT @KP",
            "identifier": "0764",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aaron Brandt
• Laura E Brandt, PA-C
• Brian Branigan, BA
• Sydney Nicole Branigan
• Shawn Michael Brannan, SUDPT
• Jessica Therese Brar, M.S.W.
• Kirandeep Brar
• Loveleen Kaur Brar, B.D.S.
• Rajwant Singh Brar, RPH
• Zenia Kaur Brar, MA, MHP

• Dental Assistant in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Dental Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.