The Tooth Fairies 2 LLC

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

DH00005026 Issued in WA

Legal business name

THE TOOTH FAIRIES 2 LLC

Practice address

1840 25TH Ave NE Apt 414
Issaquah, WA 98029-2641

Phone

(425) 417-0630

NPI assigned

Aug 20, 2009

Last updated

Aug 20, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Helen Elise Tanner, RDH, BSNPI 1972719359

Title

President

Phone

(425) 417-0630

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Helen Elise Tanner, RDH, BS

  • Dental Hygienist
  • Issaquah, WA
  • NPI 1972719359
  NPD (past) Authorized official

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250726400000",
    "number": "1912139106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 25TH AVE NE APT 414",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980292641",
            "telephone_number": "425-417-0630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 25TH AVE NE APT 414",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980292641",
            "telephone_number": "425-417-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE TOOTH FAIRIES 2 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-20",
        "last_updated": "2009-08-20",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "HELEN",
        "authorized_official_middle_name": "ELISE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-417-0630",
        "authorized_official_credential": "RDH, BS"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WA",
            "license": "DH00005026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901897",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dental Hygienist in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Dental Hygienist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; 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.