Kristin Nordahl, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60035277 Issued in WA

Practice address

1057 12TH Ave
Longview, WA 98632-2509

Phone

(360) 636-3892

Fax

(360) 414-1114

NPI assigned

Feb 13, 2009

Last updated

Sep 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1234483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1811136898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1057 12TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322509",
            "telephone_number": "360-636-3892",
            "fax_number": "360-414-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1057 12TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322509",
            "telephone_number": "360-636-3892",
            "fax_number": "360-414-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDAHL",
        "first_name": "KRISTIN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-13",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60035277",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00131874",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5059464",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jon A Nielsen, PHARMD
• Alex L Nielson, MD
• Ray Allan Noel, M.D.
• Lynelle Nancy Noisy Hawk, MD
• Norco, Inc
• Margaret D Norman, BS, MS
• Alexis Corinne Normandeau, ME
• Northland Hearing Centers, Inc. (All American Hearing)
• Northwest Health Associates Inc
• Northwest Hearing Aid Consultants, Inc. (Miracle-Ear Center)

• General Practice Dentistry in Longview, WA
• Providers in Longview, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.