Yonatan Ahdut, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DE60479557 Issued in WA

Practice address

1901 S Union Ave
Suite B-3008
Tacoma, WA 98405-1702

Phone

(253) 572-9777

Fax

(253) 627-6766

NPI assigned

Jul 8, 2014

Last updated

Jul 8, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ahdut Bean PLLC

  dba Green Leaf Dental

  • Dental Clinic/Center
  • Seattle, WA
  • NPI 1881189322
  Authorized official Same address or phone
• George C. Brain DDS PC

  • Pediatric Dentistry
  • Tacoma, WA
  • NPI 1174617781
  NPD (past)
• Smiles 4 Kids Allenmore, P.C.

  • General Practice Dentistry
  • Tacoma, WA
  • NPI 1194151845
  NPD (past)

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404777600000",
    "number": "1811303167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6517 25TH AVE NE",
            "address_2": "APT. B",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981157160",
            "telephone_number": "253-426-5821",
            "fax_number": "253-627-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 S UNION AVE",
            "address_2": "SUITE B-3008",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051702",
            "telephone_number": "253-572-9777",
            "fax_number": "253-627-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHDUT",
        "first_name": "YONATAN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-08",
        "last_updated": "2014-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60479557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Dean Torres Aguiling, M.D.
• Douglas Eduardo Aguirre, PA-C
• Yareli Aguirre
• Cyrena Lee Aguon-Larson, LCSW
• Katherine Elizabeth Agyei Yeboah
• Brian Ahern, PA-C
• David Keith Ahern, MD
• Cossette D. Ahlborn, LMHC
• Adam Richard Ahlquist
• Mudassar Raees Ahmad, MB,BS

• Dentist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2014; 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.