Individual provider Active NPI

Jennifer Althea Barrett, DDS

  • Dentist
  • Tacoma, WA
National Provider Identifier
1962702050
Registry record updated May 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60167790 Issued in WA
Practice address
2520 N. Alder St.
Tacoma, WA 98406
Phone
(253) 572-6670
Fax
(253) 572-9982
NPI assigned
Oct 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE60167790 WA Primary

Addresses

Primary practice location

2520 N. Alder St.
Tacoma, WA 98406

Mailing address

2520 N. Alder St.
Tacoma, WA 98406
Phone (253) 572-6670

Other names 1

  • Jennifer Althea Granlund Former name

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
I20150622001495 WA Order and Referring Only - DentistPractitioner - Dentist 1557681350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE60167790WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1287878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462320000000",
    "number": "1962702050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 N. ALDER ST.",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98406",
            "telephone_number": "253-572-6670",
            "fax_number": "253-572-9982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 N. ALDER ST.",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98406",
            "telephone_number": "253-572-6670",
            "fax_number": "253-572-9982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRETT",
        "first_name": "JENNIFER",
        "middle_name": "ALTHEA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-24",
        "last_updated": "2016-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60167790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "GRANLUND",
            "middle_name": "ALTHEA",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.