Individual provider Active NPI

Alvin Thien, DDS

  • Dentist
  • Kennewick, WA
National Provider Identifier
1902983695
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE00007283 Issued in WA
Practice address
100 N Fruitland St Ste E
Kennewick, WA 99336-3814
Phone
(509) 491-3388
NPI assigned
Nov 1, 2006
Last updated
Mar 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE00007283 WA Primary

Addresses

Primary practice location

100 N Fruitland St Ste E
Kennewick, WA 99336-3814

Mailing address

100 N Fruitland St Ste E
Kennewick, WA 99336-3814
Phone (509) 491-3388

Other identifiers 3

IdentifierTypeStateIssuer
5031315MedicaidWA
0129616OtherWAWA STATE DEPT L&I NUMBER
8923242OtherWAWASHINGTON STATE DLI CV#

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160422001538 WA Order and Referring Only - DentistPractitioner - Dentist 9234438417

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE00007283WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Alvin Thien DDS, PLLC CurrentSince Mar 12, 2023 Accepting new patients
Grant County Public Hospital District No 5 Past Accepting new patients

Locations

100 N Fruitland St
Ste E
Kennewick, WA 99336
Phone (509) 491-3388

Interoperability endpoints

  • Direct secure messaging: alvin.thien.1@8515.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1902983695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N FRUITLAND ST STE E",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993363814",
            "telephone_number": "509-491-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N FRUITLAND ST STE E",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993363814",
            "telephone_number": "509-491-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIEN",
        "first_name": "ALVIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00007283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5031315",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE DEPT L&I NUMBER",
            "identifier": "0129616",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON STATE DLI CV#",
            "identifier": "8923242",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.