Individual provider Active NPI

Rachel Park Lederman, DMD

  • General Practice Dentistry
  • Bellevue, WA
National Provider Identifier
1063086692
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE61114713 Issued in WA
Practice address
14575 NE Bel Red Rd Ste 101
Bellevue, WA 98007-3908
Phone
(425) 746-6020
NPI assigned
May 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 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 DE61114713 WA Primary

Addresses

Primary practice location

14575 NE Bel Red Rd Ste 101
Bellevue, WA 98007-3908

Mailing address

14575 NE Bel Red Rd Ste 101
Bellevue, WA 98007-3908
Phone (425) 746-6020

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
DE61114713WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lederman & Lederman PLLC General Practice PastSince May 25, 2021 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1063086692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14575 NE BEL RED RD STE 101",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073908",
            "telephone_number": "425-746-6020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14575 NE BEL RED RD STE 101",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073908",
            "telephone_number": "425-746-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDERMAN",
        "first_name": "RACHEL",
        "middle_name": "PARK",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-18",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61114713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.