Unknown Individual – Dentist, NPI 1174524201

Dentist

Unknown Individual is a healthcare provider. based in Puyallup, Washington. specializing in Dentist. They hold a License No. 6744 (WA). The NPI Number for Unknown Individual is 1174524201

Main info

Organization

Inactive

Name

Unknown Individual

NPI

1174524201

Phone

(253) 770-0529

Address

8114 112TH STREET CT E

Deactivation Date

13 January 2021

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness75

Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

8114 112TH STREET CT E
#A
PUYALLUP, WA 983737820
Phone: (253) 770-0529
Fax: (253) 770-9638
Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98373)

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Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?

In the U.S., Unknown Individual is identified by NPI 1174524201.

Should I call the clinic if Unknown Individual is inactive here?

If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.

What does the directory say Unknown Individual does?

Insurance directories may phrase it differently, but here Unknown Individual maps to Dentist. Clinical services aligned with this taxonomy classification.

What geographic area is tied to Unknown Individual?

Unknown Individual is associated with Puyallup, Washington in the same public data insurers reference.

Can I export Unknown Individual's record?

You can download the official NPPES record; we summarize key fields for readability.