NPIMap

Organization Active NPI

Trina Bruchal, DMD, PLLC

Doing business as Bruchal Orthodontics

  • Dental Clinic/Center
  • Bothell, WA
National Provider Identifier
1033411053
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DE00010886 Issued in WA
Legal business name
TRINA BRUCHAL, DMD, PLLC
Doing business as
Bruchal Orthodontics
Practice address
12900 NE 180TH St Ste 215
Bothell, WA 98011-5773
Phone
(425) 939-8428
Fax
(425) 939-8418
NPI assigned
Nov 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Authorized official

Name
Dr. Trina Marie Bruchal, DMDNPI 1023208501
Title
Owner/Orthodontist
Phone
(425) 939-8428

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DE00010886 WA Primary

Addresses

Primary practice location

12900 NE 180TH St Ste 215
Bothell, WA 98011-5773

Mailing address

12900 NE 180TH St Ste 215
Bothell, WA 98011-5773
Phone (425) 939-8428

Other identifiers 1

IdentifierTypeStateIssuer
1023208501MedicaidWA

Other names 1

  • Bruchal Orthodontics Doing business as

National Provider Directory

National Provider Directory

Locations

12900 NE 180th St
Ste 215
Bothell, WA 98011
Phone (425) 939-8428

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355184000000",
    "number": "1033411053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12900 NE 180TH ST STE 215",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980115773",
            "telephone_number": "425-939-8428",
            "fax_number": "425-939-8418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900 NE 180TH ST STE 215",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980115773",
            "telephone_number": "425-939-8428",
            "fax_number": "425-939-8418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINA BRUCHAL, DMD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-23",
        "last_updated": "2012-12-11",
        "status": "A",
        "authorized_official_last_name": "BRUCHAL",
        "authorized_official_first_name": "TRINA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/ORTHODONTIST",
        "authorized_official_telephone_number": "425-939-8428",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "DE00010886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023208501",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bruchal Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; 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.