Individual provider Active NPI

Jessica P Saepoff, DDS

  • Dentist
  • Issaquah, WA
National Provider Identifier
1033212147
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
240 NW Gilman Blvd Ste 114
Issaquah, WA 98027-2418
Phone
(425) 427-8899
Fax
(425) 427-9462
NPI assigned
Sep 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X WA Primary

Addresses

Primary practice location

240 NW Gilman Blvd Ste 114
Issaquah, WA 98027-2418

Mailing address

240 NW Gilman Blvd Ste 114
Issaquah, WA 98027-2418
Phone (425) 427-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jun 16, 2016 through Jun 16, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
601881234WASTWAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033212147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 NW GILMAN BLVD STE 114",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272418",
            "telephone_number": "425-427-8899",
            "fax_number": "425-427-9462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 NW GILMAN BLVD STE 114",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272418",
            "telephone_number": "425-427-8899",
            "fax_number": "425-427-9462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAEPOFF",
        "first_name": "JESSICA",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

Verify at the official NPI Registry.