Provider Demographics
NPI:1760203731
Name:TAMASAS, BASMA (BDS, MS, MSD, PHD)
Entity type:Individual
Prefix:
First Name:BASMA
Middle Name:
Last Name:TAMASAS
Suffix:
Gender:F
Credentials:BDS, MS, MSD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2702 S 42ND ST STE 106
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-7315
Mailing Address - Country:US
Mailing Address - Phone:253-472-7788
Mailing Address - Fax:
Practice Address - Street 1:2702 S 42ND ST STE 106
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-7315
Practice Address - Country:US
Practice Address - Phone:253-472-7788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE611562891223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics