Shin Deng, DE61266510

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE61266510 Issued in WA

Practice address

3820 Pacific Ave
Tacoma, WA 98418-7825

Phone

(253) 472-3016

NPI assigned

Aug 24, 2022

Last updated

Aug 24, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1871212654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 106TH AVE NE UNIT 515",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980048696",
            "telephone_number": "206-787-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 PACIFIC AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984187825",
            "telephone_number": "253-472-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENG",
        "first_name": "SHIN",
        "credential": "DE61266510",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61266510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colette Demonte, PSY.D.
• Callum Mellor Dempsey, D.O.
• Patricia Irene Dempsey, PH.D.
• David W Dempster, MD
• Logan Andrew Denen
• Sara Michelle Denis
• Steven Denler, MA, LMHC
• Julia Denney
• Cory Daniel Dennis, LMP
• Jamila Nandi Dennis

• General Practice Dentistry in Tacoma, WA
• Providers in Tacoma, 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 Aug 24, 2022; 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.