1. Home
  2. Directory
  3. Washington
  4. Longview
  5. Dentist
  6. NPI Profile

JUSTIN TAN DDS
NPI 1235536475
Dentist - General Practice in Longview, WA

Active since December 03, 2014
1057 12TH AVE, LONGVIEW, WA 98632(360) 414-1300 Get Directions Write a Review

NPPES record last updated: December 3, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Justin Tan Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JUSTIN TAN DDS (NPI 1235536475) is an individual general practice provider in Longview, Washington, licensed in Washington (DE60502542) and active in the NPI registry since December 2014.

NPPES Registry Identity

NPI1235536475
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameJUSTIN TANCredential: DDS
Location Address1057 12TH AVELongview, WA 98632-2509
Mailing Address1057 12th AveLongview, WA 98632-2509 · (360) 414-1300
Phone(360) 414-1300
Sole ProprietorNo
Enumeration DateDecember 3, 2014
✔ NPI 1235536475 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in WA · DE60502542
Definition
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.
1057 12TH AVE, Longview, WA 98632
Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DIAN COOPER
Counselor (Mental Health)
1057 12TH AVE
LONGVIEW, WA 98632
Cowlitz County (360) 636-3892
SARA DERENGE ARNP
Nurse Practitioner (Women's Health)
1057 12TH AVE
LONGVIEW, WA 98632
Cowlitz County (360) 636-3892
PATRICIA S GOODMAN RD
Dietitian, Registered
1057 12TH AVE
LONGVIEW, WA 98632
Cowlitz County (360) 423-7740
LYNDSEY SMITH DENTAL HYGIENIST
Dental Hygienist
1057 12TH AVE
LONGVIEW, WA 98632
Cowlitz County (360) 414-1300
COWLITZ FAMILY HEALTH CENTER
Clinic/Center (Federally Qualified Health Center (FQHC))
1057 12TH AVE
LONGVIEW, WA 98632
Cowlitz County (360) 636-3892
CHARLOTTE M BUTTON
Dietitian, Registered
1057 12TH AVE
LONGVIEW, WA 98632
Cowlitz County (360) 423-7740
DIANA SHIELDS ARNP
Nurse Practitioner (Family)
1057 12TH AVE
LONGVIEW, WA 98632
Cowlitz County (360) 636-3892
LISA CRUZ MSW
Social Worker
1057 12TH AVE
LONGVIEW, WA 98632
Cowlitz County (360) 423-7740

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Justin Tan's NPI number?

The NPI number for Justin Tan is 1235536475. It was assigned to this individual provider in the NPPES registry on December 3, 2014.

Where is Justin Tan located?

Justin Tan practices at 1057 12th Ave, Longview, WA 98632. The listed phone number is (360) 414-1300.

What is Justin Tan's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Justin Tan was last updated on December 3, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.