Active NPI
Kaylee Wonder, DMD
- Dentist
- Poulsbo, WA
National Provider Identifier
1033630165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE60771805
- Practice address
- 19410 8TH Ave NE Ste 102
Poulsbo, WA 98370-7379 - Phone
- (360) 779-1566
- NPI assigned
- Jun 28, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | DE60771805 | WA | Primary |
Addresses
Primary practice location
19410 8TH Ave NE Ste 102
Poulsbo, WA 98370-7379
Mailing address
1147 Loyola St NE
Olympia, WA 98516-5451
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE60771805 | WA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaylee Wonder DMD PLLC | Past | Accepting new patients | |
| Anderson Denture Center, Inc. | Past | Accepting new patients |
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.
-
- Dental Clinic/Center
- Poulsbo, WA
- NPI 1326566241
-
- Denturist
- Poulsbo, WA
- NPI 1366761181
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1499904000000",
"number": "1033630165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1147 LOYOLA ST NE",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985165451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19410 8TH AVE NE STE 102",
"city": "POULSBO",
"state": "WA",
"postal_code": "983707379",
"telephone_number": "360-779-1566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WONDER",
"first_name": "KAYLEE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-28",
"last_updated": "2017-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE60771805",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poulsbo, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.