Active NPI
Ethan Earl Tindall, DDS
- Dentist
- Tacoma, WA
National Provider Identifier
1841785730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DDS-09582
- Practice address
- 9900 Lincoln St, 2ND Floor
US Army Dentac
Tacoma, WA 98327 - Phone
- (253) 968-4079
- Fax
- (253) 968-5919
- NPI assigned
- Jun 25, 2018
- 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 | DDS-09582 | IA | Primary |
Addresses
Primary practice location
9900 Lincoln St, 2ND Floor
US Army Dentac
Tacoma, WA 98327
Mailing address
9900 Lincoln St, 2ND Floor
US Army Dentac
Tacoma, WA 98327
Phone (253) 968-4079
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 |
|---|---|---|---|
| DDS-09582 | IA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529884800000",
"number": "1841785730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9900 LINCOLN ST, 2ND FLOOR",
"address_2": "US ARMY DENTAC",
"city": "TACOMA",
"state": "WA",
"postal_code": "98327",
"telephone_number": "253-968-4079",
"fax_number": "253-968-5919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9900 LINCOLN ST, 2ND FLOOR",
"address_2": "US ARMY DENTAC",
"city": "TACOMA",
"state": "WA",
"postal_code": "98327",
"telephone_number": "253-968-4079",
"fax_number": "253-968-5919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TINDALL",
"first_name": "ETHAN",
"middle_name": "EARL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-25",
"last_updated": "2018-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IA",
"license": "DDS-09582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.