Thalia-Rae Perryman, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D11463 Issued in OR

Practice address

1625 SE 192ND Ave # 205
Camas, WA 98607-7441

Phone

(360) 835-6001

Fax

(360) 835-6002

NPI assigned

Jun 11, 2015

Last updated

May 2, 2024By the provider in NPPES

Sex

Female

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

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Thalia-Rae Criddle PLLC

  dba Criddle Concierge

  • Dental Clinic/Center
  • Camas, WA
  • NPI 1063181709
  NPD

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1881075182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 SE 192ND AVE STE 205",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986076505",
            "telephone_number": "360-835-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 SE 192ND AVE # 205",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986077441",
            "telephone_number": "360-835-6001",
            "fax_number": "360-835-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRYMAN",
        "first_name": "THALIA-RAE",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D11463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Noel Payne, PTA
• Peak Motion, PLLC (Fyzical Therapy & Balance Centers)
• Sharon Muff Peddie, OTR/L
• Dina Peganoff, PHYSICAL THERAPIST A
• Pelvic Pro Therapy, LLC
• Esther Pfeiffer
• Tara L Pfund
• David Andrew Philips, M.D.
• PHS LLC (SureCare Rx)
• Physical Therapy Associates of Camas

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.