Active NPI
Arturo Bravo, DDS
- General Practice Dentistry
- Wenatchee, WA
National Provider Identifier
1013908680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DE00007453
- Practice address
- 600 Orondo Ave
Ste 1
Wenatchee, WA 98801-2800 - Phone
- (509) 662-6000
- NPI assigned
- Nov 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DE00007453 | WA | Primary |
Addresses
Primary practice location
600 Orondo Ave
Ste 1
Wenatchee, WA 98801-2800
Mailing address
2325 Fancher Heights Blvd
East Wenatchee, WA 98802-8553
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5300090 | Medicaid | WA |
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161024002298 | WA | Order and Referring Only - Other (Non-Physician) | 2365720430 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE00007453 | WA | MD | General Practice Dentistry |
Interoperability endpoints
- abravo452642@direct.multicare.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013908680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2325 FANCHER HEIGHTS BLVD",
"city": "EAST WENATCHEE",
"state": "WA",
"postal_code": "988028553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 ORONDO AVE",
"address_2": "STE 1",
"city": "WENATCHEE",
"state": "WA",
"postal_code": "988012800",
"telephone_number": "509-662-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAVO",
"first_name": "ARTURO",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "DE00007453",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5300090",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wenatchee, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.