Individual provider Active NPI

Violeta Atanasova Stoyanova, DDS

  • General Practice Dentistry
  • Puyallup, WA
National Provider Identifier
1033614276
Registry record updated Sep 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE60935909 Issued in WA
Practice address
12005 Meridian E Ste 102
Puyallup, WA 98373-3423
Phone
(253) 214-9293
NPI assigned
Mar 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE60935909 WA Primary

Addresses

Primary practice location

12005 Meridian E Ste 102
Puyallup, WA 98373-3423

Mailing address

21206 SE 270TH St
Maple Valley, WA 98038-3142
Phone (805) 453-1117

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
I20200402001768 WA Order and Referring Only - DentistPractitioner - Dentist 1153750757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE60935909WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Dental Corporation, PC CurrentSince Oct 19, 2020 Accepting new patients
Marquis Family Dentistry General Practice PastSince Oct 1, 2019 Accepting new patients

Locations

12005 Meridian E
#102
Puyallup, WA 98373
Phone (253) 214-9293

Networks

  • WA PPO C-SNP

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630886400000",
    "number": "1033614276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21206 SE 270TH ST",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980383142",
            "telephone_number": "805-453-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12005 MERIDIAN E STE 102",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733423",
            "telephone_number": "253-214-9293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOYANOVA",
        "first_name": "VIOLETA",
        "middle_name": "ATANASOVA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2021-09-06",
        "certification_date": "2021-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60935909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.