TIETAN DENTAL TEAM
NPI 1912124637
Dentist in Walla Walla, WA

Q: What is Kellogg & Kellogg Ps's NPI number?

The NPI number for Kellogg & Kellogg Ps is 1912124637. It was assigned to this organization in the NPPES registry on April 20, 2007. The provider is also known as Tietan Dental Team.

Q: What is Kellogg & Kellogg Ps's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Active since April 20, 2007

1602 PENNY LN, WALLA WALLA, WA 99362(509) 522-0940(509) 525-9063 Get Directions Write a Review

NPPES record last updated: May 31, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Tietan Dental Team NPPES

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

TIETAN DENTAL TEAM (NPI 1912124637) is a healthcare organization registered as a dentist in Walla Walla, Washington and active in the NPI registry since April 2007. The organization lists Don R Kellogg, Secretary, as its authorized official.

NPPES Registry Identity

NPI1912124637

Entity TypeOrganization

Primary Taxonomy122300000X

Legal Business NameKELLOGG & KELLOGG PS

Location Address1602 PENNY LNWalla Walla, WA 99362-4477

Mailing Address1602 Penny LnWalla Walla, WA 99362-4477 · (509) 522-0940 · Fax (509) 525-9063

Phone(509) 522-0940

Fax(509) 525-9063

Organization SubpartNo

Authorized OfficialDon R KelloggSecretary · (509) 522-0940

Enumeration DateApril 20, 2007

Last NPPES UpdateMay 31, 2013

✔ NPI 1912124637 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in WA · DE00004225

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

1602 PENNY LN, Walla Walla, WA 99362

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Other Names 1

Other NameTietan Dental Team

Other Identifiers 1

Medicaid5023346WA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

Other Providers at the Same Location NPPES 5

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

MR. CHAD T. ORDELHEIDE DDS

Dentist (General Practice)