Active NPI
Beth A O'Connor, D.D.S.
- Dentist
- Tacoma, WA
National Provider Identifier
1982615951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6491
- Practice address
- 9618 59TH Ave SW
Tacoma, WA 98499-2799 - Phone
- (253) 584-2124
- Fax
- (253) 588-1463
- NPI assigned
- Aug 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 6491 | WA | Primary |
Addresses
Primary practice location
9618 59TH Ave SW
Tacoma, WA 98499-2799
Mailing address
9618 59TH Ave SW
Tacoma, WA 98499-2799
Phone (253) 584-2124
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Mar 28, 2017 through Mar 28, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6491 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982615951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9618 59TH AVE SW",
"city": "TACOMA",
"state": "WA",
"postal_code": "984992799",
"telephone_number": "253-584-2124",
"fax_number": "253-588-1463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9618 59TH AVE SW",
"city": "TACOMA",
"state": "WA",
"postal_code": "984992799",
"telephone_number": "253-584-2124",
"fax_number": "253-588-1463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "O'CONNOR",
"first_name": "BETH",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "6491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.