Timothy Noel Tanada, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DE009820 Issued in WA

Practice address

19221 SE 34TH Street
Camas, WA 98607

Phone

(360) 882-9595

NPI assigned

May 1, 2007

Sex

Male

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 OR

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Premiere Dental

  • General Practice Dentistry
  • Camas, WA
  • NPI 1902021777
  NPD (past)

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952522716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11405 SW IRONWOOD LOOP",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972234231",
            "telephone_number": "503-869-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19221 SE 34TH STREET",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "98607",
            "telephone_number": "360-882-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANADA",
        "first_name": "TIMOTHY",
        "middle_name": "NOEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE009820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Aniko Szabo, LMP
• Bonnie Lee Taylor, LMP
• Sandra Weis Taylor, M.S., CCC-SLP
• Michael D Teater, PT, DPT, OCS
• Terrain Wellness LLC
• Thalia-Rae Criddle PLLC

• 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 Jul 8, 2007; 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.