MOBILE DENTAL NORTHWEST, LLC (NPI# 1700148152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700148152 |
| Entity Type | Organization |
| Organization Name | MOBILE DENTAL NORTHWEST, LLC |
| Practice Address |
1622 S Mildred St Suite B Tacoma WA 98465-1610 |
| Practice Telephone | 2534324795 |
| Mailing Telephone | 2534324795 |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2012-06-12 |
| Authorized Official Name | DR. GREGORY ROBERT FISHER (VICE PRESIDENT- FINANCE) |
| Authorized Official Telephone | 2534324795 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
4923 | WA | Dental Providers |
| Street Address |
1622 S MILDRED ST SUITE B |
| City | TACOMA |
| State | WA |
| Zip Code | 98465-1610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922329713 | Alan Arthur Anderson | Denturist | 1622 S Mildred St, Suite A, Tacoma, WA 98465-1610 | 2010-06-16 |
| 1033596531 | Vahideh Yousefi | Dentist | 1622 S Mildred St, Tacoma, WA 98465-1610 | 2015-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013378025 | Shauna Lea Irish | Occupational Therapist | 8446 S. 17th Street, Tacoma, WA 98465 | 2016-03-18 |
| 1538533567 | Katherine Elizabeth Fakih | Massage Therapist | 1002 S. Pearl St., Tacoma, WA 98465 | 2015-11-13 |
| 1992932669 | Sandra Christian | Registered Nurse | 1201 S. Proctor, Comprehensive Mental Health/pearl Street Center, Tacoma, WA 98465 | 2009-06-19 |
| 1629202627 | Priyan Perera | Internal Medicine | 815 S Vassault St, Tacoma, WA 98465 | 2009-05-06 |
| 1306089941 | Kristin A. Hummel-sauerwein | Counselor | Comprehensive Mental Health / Pearl Street Center, 1201 Proctor Street, Tacoma, WA 98465 | 2009-04-13 |
| 1891950630 | Allen Douglas Webb Jr. | Psychiatric Residential Treatment Facility | 815 S Pearl, Pearl Street Center, Tacoma, WA 98465 | 2008-07-22 |
| 1598964470 | Hardtke's House Calls, LLC | Nurse Practitioner | 1540 Ventura Dr, Tacoma, WA 98465 | 2007-07-12 |
| 1013054543 | Advanced Lifeline Services Inc | Respiratory Therapist, Certified | 630 South Pearl, Tacoma, WA 98465 | 2007-02-01 |
| 1508952680 | Mary Ann Woodruff | Pediatrics | 1628 South Mildred, #101, Tacoma, WA 98465 | 2006-10-05 |
| 1427573989 | Mamta Shankar | Pharmacist | 1850 S Mildred St, Tacoma, WA 98465 | 2017-08-06 |
| Find all providers in zip 98465 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528672078 | Christopher Hieu-thanh Nguyen | Dentist | Madigan Annex Second Floor Building 9900, Tacoma, WA 98431-0001 | 2020-09-02 |
| 1699308619 | Gaurav Dudeja Pllc | Dentist | 5038 Tacoma Mall Blvd Ste A, Tacoma, WA 98409-7103 | 2020-02-18 |
| 1477032035 | Sampada Jayant Deshpande | Dentist | 4811 Wa Tau Ga Ave Ne, Tacoma, WA 98422-1799 | 2018-08-14 |
| 1962996272 | William Thomas Frei | Dentist | 9900 Lincoln St, 2nd Floor, Attn: Credentials Office, Us Army Dentac, Tacoma, WA 98327 | 2018-06-20 |
| 1720598949 | Alyssa Christine Meister Burns | Dentist | 9900 Lincoln Street (2nd Floor), Tacoma, WA 98431-0001 | 2017-10-02 |
| 1528503141 | Ajaipal Singh Sekhon, Dds, Pllc | Dentist | 2716 N 31st St, Tacoma, WA 98407-6405 | 2017-01-05 |
| 1730543240 | Dale L. Vanderschelden, Dds Chartered | Dentist | 5003 Tacoma Mall Blvd Ste 103, Tacoma, WA 98409-7120 | 2016-04-11 |
| 1639552110 | Philip Henzlik | Dentist | 9900 Lincoln St. 2nd Floor, Us Army Dentac, Tacoma, WA 98327 | 2015-07-02 |
| 1639599566 | Adam Yang Dds Ps | Dentist | 15 Oregon Ave Ste 106, Tacoma, WA 98409-7462 | 2014-04-17 |
| 1265778484 | Richard Guzha Dds LLC | Dentist | 2617 6th Ave, Tacoma, WA 98406-7204 | 2012-12-15 |
| Find all providers in TACOMA | ||||
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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.