Provider Demographics
NPI:1134478795
Name:STONE, TRISTAN J (DDS)
Entity Type:Individual
Prefix:
First Name:TRISTAN
Middle Name:J
Last Name:STONE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 LISA LN
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-2318
Mailing Address - Country:US
Mailing Address - Phone:425-761-9195
Mailing Address - Fax:
Practice Address - Street 1:1420 KING ST STE B
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-6264
Practice Address - Country:US
Practice Address - Phone:360-671-4552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE606061511223D0001X
TN96121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Yes1223D0001XDental ProvidersDentistDental Public Health