Tate Keone Nobuo Masunaga, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

60865193 Issued in WA

Practice address

20709 Mountain Hwy E Ste 101
Spanaway, WA 98387-8580

Phone

(253) 948-0879

NPI assigned

Apr 21, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1972038420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 WESTLAKE AVE N UNIT 539",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981094881",
            "telephone_number": "808-349-5953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20709 MOUNTAIN HWY E STE 101",
            "city": "SPANAWAY",
            "state": "WA",
            "postal_code": "983878580",
            "telephone_number": "253-948-0879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5225 Kuaiwi Pl Apt B",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968211567",
            "country_code": "US",
            "telephone_number": "808-349-5953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASUNAGA",
        "first_name": "TATE",
        "middle_name": "KEONE NOBUO",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-21",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "60865193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yun Suk Mann, NAC
• Heather Lea Marsh
• Dominique Martin-Mitchell, OTR/L
• Lindsay Elizabeth Martin
• Ashley Martinez, LICSW, PMH-C
• Laura L McDonald, RN
• Leonida Juana McGowan, RN, BSN
• Michelle McNamara
• Patricia Ann Medici, LMP
• Memorable Care Homes LLC

• Dentist in Spanaway, WA
• Providers in Spanaway, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.