Individual provider Active NPI

Kimberly Marie Espinoza, DDS

  • Dentist
  • Seattle, WA
National Provider Identifier
1003844770
Registry record updated Jul 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DEFC.DF.60476251 Issued in WA
Practice address
1959 NE Pacific St
Box 356370
Seattle, WA 98195-6370
Phone
(206) 543-6501
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X TD0014 NM
Dentist 122300000X DEFC.DF.60476251 WA Primary
Dentist 122300000X DD3166 NM

Addresses

Primary practice location

1959 NE Pacific St
Box 356370
Seattle, WA 98195-6370

Mailing address

University of Washington School of Dentistry
Box 356370
Seattle, WA 98195-6370
Phone (206) 543-6501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160427002100 WA Order and Referring Only - DentistPractitioner - Dentist 6507162161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DD3166NMMDDentist
TD0014NMMDDentist
DEFC.DF.60476251WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404777600000",
    "number": "1003844770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF WASHINGTON SCHOOL OF DENTISTRY",
            "address_2": "BOX 356370",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981956370",
            "telephone_number": "206-543-6501",
            "fax_number": "206-685-8412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "address_2": "BOX 356370",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981956370",
            "telephone_number": "206-543-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPINOZA",
        "first_name": "KIMBERLY",
        "middle_name": "MARIE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2014-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "TD0014",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DEFC.DF.60476251",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD3166",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.