Individual provider Active NPI

Jonathan Huang, DDS MS PHD

  • Dentist
  • Edmonds, WA
National Provider Identifier
1033635495
Registry record updated Aug 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60775313 Issued in WA
Practice address
21727 76TH Ave W Ste 110
Edmonds, WA 98026-7549
Phone
(425) 775-1055
NPI assigned
Aug 17, 2017
Last updated
Aug 17, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE60775313 WA Primary

Addresses

Primary practice location

21727 76TH Ave W Ste 110
Edmonds, WA 98026-7549

Mailing address

19817 Sunnyside Dr N Apt J301
Shoreline, WA 98133-2714

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
Credentials
Master of Science, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
DE60775313WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan Huang DMD Ms PHD and Michiko Huang DDS Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502928000000",
    "number": "1033635495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19817 SUNNYSIDE DR N APT J301",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981332714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21727 76TH AVE W STE 110",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267549",
            "telephone_number": "425-775-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUANG",
        "first_name": "JONATHAN",
        "credential": "DDS MS PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-17",
        "last_updated": "2017-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60775313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.

Verify at the official NPI Registry.