Individual provider Active NPI

James Randall Bird, DDS

  • General Practice Dentistry
  • West Richland, WA
National Provider Identifier
1952696551
Registry record updated Oct 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE 60274666 Issued in WA
Practice address
4900 Paradise Way
Suite 104
West Richland, WA 99353-7949
Phone
(509) 581-0626
NPI assigned
Jun 13, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE 60274666 WA Primary

Addresses

Primary practice location

4900 Paradise Way
Suite 104
West Richland, WA 99353-7949

Mailing address

4900 Paradise Way
Suite 104
West Richland, WA 99353-7949
Phone (509) 581-0626

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
I20150702001874 WA Order and Referring Only - DentistPractitioner - Dentist 0749592897

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE 60274666WAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476403200000",
    "number": "1952696551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 PARADISE WAY",
            "address_2": "SUITE 104",
            "city": "WEST RICHLAND",
            "state": "WA",
            "postal_code": "993537949",
            "telephone_number": "509-581-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 PARADISE WAY",
            "address_2": "SUITE 104",
            "city": "WEST RICHLAND",
            "state": "WA",
            "postal_code": "993537949",
            "telephone_number": "509-581-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRD",
        "first_name": "JAMES",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-13",
        "last_updated": "2016-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE 60274666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Richland, WA

Sources for this page

Verify at the official NPI Registry.