Individual provider Active NPI

Ethan Daniel Zuker, D.M.D.

  • Dentist
  • Kennewick, WA
National Provider Identifier
1962723957
Registry record updated Jul 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60273197 Issued in WA
Practice address
7501 W Deschutes PL
Kennewick, WA 99336-7719
Phone
(509) 783-1960
NPI assigned
Jun 14, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12011485A IN
Dentist 122300000X DE60273197 WA Primary

Addresses

Primary practice location

7501 W Deschutes PL
Kennewick, WA 99336-7719

Mailing address

7501 W Deschutes PL
Kennewick, WA 99336-7719
Phone (509) 783-1960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12011485AINMDDentist
DE60273197WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1962723957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 W DESCHUTES PL",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367719",
            "telephone_number": "509-783-1960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 W DESCHUTES PL",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367719",
            "telephone_number": "509-783-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZUKER",
        "first_name": "ETHAN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-14",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011485A",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60273197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; 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.