Rodriguez, Tyrone Fernando
Rodriguez, Tyrone Fernando is an individual health care provider with primary practice located at 825 Sharon Ave E , Moses Lake WA 98837-2441. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Rodriguez, Tyrone Fernando can be contacted via phone (509) 766-9030.Contact Information
Primary practice address
825 Sharon Ave E
Moses Lake WA 98837-2441
Phone: (509) 766-9030
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | DE00010610 | Washington |
| Dental Providers / Pediatric Dentistry | 1223P0221X | 21889 | Texas |
Profile Details
| NPI number | 1366598880 |
|---|---|
| LBN Legal business name | Rodriguez, Tyrone Fernando |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 26th, 2007 |
| Last updated | Feb 29th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366598880 | NPPES |
| Washington | Other | 5051248 | CHPW |
| Washington | Other | 911019392 | CHPW |
| Washington | Other | 0212066 | CHPW |
| Washington | MEDICAID | 5051248 | CHPW |
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