Individual provider Active NPI

Devin Kay Lindstrom, DMD

  • Dentist
  • Enumclaw, WA
National Provider Identifier
1053962795
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
60960121 Issued in WA
Practice address
2660 Griffin Ave
Enumclaw, WA 98022-2325
Phone
(206) 371-6621
NPI assigned
Sep 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 60960121 WA Primary

Addresses

Primary practice location

2660 Griffin Ave
Enumclaw, WA 98022-2325

Mailing address

40803 218TH Ave SE
Enumclaw, WA 98022-8967
Phone (206) 371-6621

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

LicenseStateTypeSpecialty
60960121WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1053962795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40803 218TH AVE SE",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980228967",
            "telephone_number": "206-371-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 GRIFFIN AVE",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980222325",
            "telephone_number": "206-371-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSTROM",
        "first_name": "DEVIN",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-24",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "60960121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enumclaw, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; 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.