NPIMap

Organization Active NPI

Byronsmizuha DMD,MSD, PS

  • Advanced Practice Dental Therapist
  • Lynnwood, WA
National Provider Identifier
1003269473
Registry record updated Jul 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice Dental TherapistTaxonomy code 125K00000X
License
4650 Issued in WA
Legal business name
BYRONSMIZUHA DMD,MSD, PS
Practice address
19320 40TH Ave W Ste B
Lynnwood, WA 98036-4602
Phone
(425) 771-3000
Fax
(425) 771-1319
NPI assigned
Jul 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Byron S. Mizuha
Title
Periodontist
Phone
(425) 771-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Dental TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 125K00000X 4650 WA Primary

Addresses

Primary practice location

19320 40TH Ave W Ste B
Lynnwood, WA 98036-4602

Mailing address

19320 40TH Ave W Ste B
Lynnwood, WA 98036-4602
Phone (425) 771-3000

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468972800000",
    "number": "1003269473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19320 40TH AVE W STE B",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364602",
            "telephone_number": "425-771-3000",
            "fax_number": "425-771-1319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19320 40TH AVE W STE B",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364602",
            "telephone_number": "425-771-3000",
            "fax_number": "425-771-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BYRONSMIZUHA DMD,MSD, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-20",
        "last_updated": "2016-07-20",
        "status": "A",
        "authorized_official_last_name": "MIZUHA",
        "authorized_official_first_name": "BYRON",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PERIODONTIST",
        "authorized_official_telephone_number": "425-771-3000",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "125K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Advanced Practice Dental Therapist",
            "state": "WA",
            "license": "4650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.