DR. KYLE T FUKANO (NPI# 1407951973) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407951973 |
| Entity Type | Individual |
| Full Name | DR. KYLE T FUKANO |
| Credential | DDS |
| Practice Address |
1684 Main St Suite 4 Freeland WA 98249 |
| Mailing Address |
Po Box 729 Freeland WA 98249-0729 |
| Practice Telephone | 3603315211 |
| Practice Fax Number | 3603315212 |
| Mailing Telephone | 3603315211 |
| Mailing Fax Number | 3603315212 |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2015-12-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DE00008801 | WA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | DDS LICENSE | DE00008801 | 01 |
| Street Address |
1684 MAIN ST SUITE 4 |
| City | FREELAND |
| State | WA |
| Zip Code | 98249 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407470420 | Whidbey Medical Equipment Supply LLC | Durable Medical Equipment & Medical Supplies | 1705 Main Street, Freeland, WA 98249 | 2020-06-05 |
| 1679029284 | Theresa Marie Leonard | Pharmacist | 1409 East Main Street, Freeland, WA 98249 | 2016-09-01 |
| 1255717468 | Leonardo Franzese | Naprapath | 5492 S Myrtle Avenue, Freeland, WA 98249 | 2015-08-11 |
| 1356748255 | Thrifty Payless Inc | Durable Medical Equipment & Medical Supplies | 1609 East Main Street, Freeland, WA 98249 | 2014-11-21 |
| 1417373960 | Mary Roberts | Counselor | 1659 Layton Rd, Freeland, WA 98249 | 2014-03-07 |
| 1275958142 | Kerry Elizabeth Kurtz | Massage Therapist | 5565 Lotto Ave, Freeland, WA 98249 | 2014-02-28 |
| 1235471897 | Allison Blackwell | Physical Therapist | 5522 S. Freeland Ave, Freeland, WA 98249 | 2013-03-21 |
| 1295074672 | Elizabeth Lesure | Massage Therapist | Island Athletic Club, Freeland Ave. At Hwy. 525, Freeland, WA 98249 | 2013-02-05 |
| 1568727386 | Tonah Leigh Potter | Speech-Language Pathologist | 5508 Harbor Avenue, Freeland, WA 98249 | 2012-07-09 |
| 1881977148 | Harbor Physical Therapy and Wellness Clinic | Physical Therapist | 5508 Harbor Ave, Freeland, WA 98249 | 2011-09-23 |
| Find all providers in zip 98249 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447445796 | Robert William Davidson | Dentist | 9625 Pierce Rd, Freeland, MI 48623-8102 | 2007-09-10 |
| 1649496753 | Joseph Anthony Donato | Dentist | 617 Centre St, Freeland, PA 18224-1910 | 2007-04-17 |
| 1952481244 | Joseph Michael Della Croce Jr. | Dentist | 458 Centre St, Freeland, PA 18224 | 2006-10-17 |
| 1306921432 | John J Della Croce | Dentist | 450 Washington St, Freeland, PA 18224 | 2006-10-26 |
| 1265522510 | David A Vrba | Dentist | 404 Ridge Street, Freeland Health Center, Freeland, PA 18224-1805 | 2006-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851991319 | Ashley Lynn Wildhaber | Dentist | 111 Tumwater Blvd Se # 301, Tumwater, WA 98501-6400 | 2020-10-26 |
| 1124627757 | Eric Kun Kim | Dentist | 7160 Burden Blvd Ste 102, Pasco, WA 99301-4469 | 2020-10-24 |
| 1174121966 | Brandon C Hahn | Dentist | 6574 153rd Ave Se, Bellevue, WA 98006-5424 | 2020-10-13 |
| 1144828237 | William Garcia | Dentist | 1214 Sw Scotton Way Ste 101, Battle Ground, WA 98604-2715 | 2020-10-12 |
| 1568069391 | Neha Agarwal | Dentist | 13605 Ne 10th Pl # 8-101, Bellevue, WA 98005-2743 | 2020-10-05 |
| 1134736028 | Ibraheem M Al Naqshabandy | Dentist | 4747 30th Ave Ne Apt K174, Seattle, WA 98105-4032 | 2020-09-25 |
| 1598371866 | Maryam Tabarestani | Dentist | 24325 7th Pl W, Bothell, WA 98021-8525 | 2020-09-21 |
| 1922614890 | Vicky Herrera | Dentist | 10720 5th Ave Ne Apt 605, Seattle, WA 98125-7258 | 2020-09-16 |
| 1407461825 | Jangsu Kiyoshi | Dentist | 3006 Mahogany St Ne, Lacey, WA 98516-5589 | 2020-09-11 |
| 1407461270 | Crisafulli Dental | Dentist | 18920 Bothell Way Ne Ste 200, Bothell, WA 98011-1981 | 2020-09-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.