Individual provider Active NPI

Emmett Nulph, DDS

  • Dentist
  • Yakima, WA
National Provider Identifier
1912912775
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE00010612 Issued in WA
Practice address
12 S 8TH St
Yakima, WA 98901-3020
Phone
(509) 454-4143
Fax
(509) 454-3651
NPI assigned
Jul 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE00010612 WA Primary

Addresses

Primary practice location

12 S 8TH St
Yakima, WA 98901-3020

Mailing address

PO Box 2605
Yakima, WA 98907-2605
Phone (509) 454-4143

Other identifiers 1

IdentifierTypeStateIssuer
5051222MedicaidWA

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
I20150420001178 WA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7214255496

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309996800000",
    "number": "1912912775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2605",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989072605",
            "telephone_number": "509-454-4143",
            "fax_number": "509-454-3651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 S 8TH ST",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989013020",
            "telephone_number": "509-454-4143",
            "fax_number": "509-454-3651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NULPH",
        "first_name": "EMMETT",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2011-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00010612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5051222",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.