Active NPI
Kamaran Shemshaki, DMD
- Dentist
- Mercer Island, WA
National Provider Identifier
1053423632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE8047
- Practice address
- 2955 80TH Ave SE
Suite #203
Mercer Island, WA 98040 - Phone
- (206) 236-2681
- Fax
- (206) 236-7221
- NPI assigned
- Aug 31, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
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 | DE8047 | WA | Primary |
Addresses
Primary practice location
2955 80TH Ave SE
Suite #203
Mercer Island, WA 98040
Mailing address
18516 NE 26 Street
Redmond, WA 98052
Phone (425) 881-9414
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181217002596 | WA | Order and Referring Only - Dentist | 3274878418 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE8047 | WA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kamran Shemshaki, DMD, PS | Current | Accepting new patients |
Locations
14150 NE 20th St
Ste F2
Bellevue, WA 98007
Phone (425) 614-1515
Networks
- WA PPO C-SNP
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": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053423632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18516 NE 26 STREET",
"city": "REDMOND",
"state": "WA",
"postal_code": "98052",
"telephone_number": "425-881-9414",
"fax_number": "425-881-9414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2955 80TH AVE SE",
"address_2": "SUITE #203",
"city": "MERCER ISLAND",
"state": "WA",
"postal_code": "98040",
"telephone_number": "206-236-2681",
"fax_number": "206-236-7221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEMSHAKI",
"first_name": "KAMARAN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE8047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mercer Island, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.