Active NPI
Thomas Charles Rhodes, DDS
- Dentist
- Puyallup, WA
National Provider Identifier
1881727592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4790
- Practice address
- 111 W Main
Puyallup, WA 98371-5331 - Phone
- (253) 845-0520
- Fax
- (253) 770-8643
- NPI assigned
- Mar 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 4790 | WA | Primary |
Addresses
Primary practice location
111 W Main
Puyallup, WA 98371-5331
Mailing address
111 W Main
Puyallup, WA 98371-5331
Phone (253) 845-0520
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5503305 | Other | WA | DEPT OF SOCIAL & HEALTH |
| 664679 | Other | WA | UNITED CONCORDIA |
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 |
|---|---|---|---|
| 4790 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340668800000",
"number": "1881727592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 W MAIN",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983715331",
"telephone_number": "253-845-0520",
"fax_number": "253-770-8643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 W MAIN",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983715331",
"telephone_number": "253-845-0520",
"fax_number": "253-770-8643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RHODES",
"first_name": "THOMAS",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-13",
"last_updated": "2012-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "4790",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF SOCIAL & HEALTH",
"identifier": "5503305",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "664679",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.