NPIMap

Organization Active NPI

House, Lee, Mast, McDonald and Nelson, PC

Doing business as Bellevue Kids Dentist

  • Dentist
  • Bellevue, WA
National Provider Identifier
1063657393
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE00008547 Issued in WA
Legal business name
HOUSE, LEE, MAST, MCDONALD AND NELSON, PC
Doing business as
Bellevue Kids Dentist
Practice address
2150 112TH Ave NE Ste a
Bellevue, WA 98004-2939
Phone
(425) 455-0784
Fax
(425) 451-3999
NPI assigned
Dec 16, 2008
Last updated
Dec 30, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
HOUSE, LEE, MAST, MCDONALD AND NELSON, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Authorized official

Name
La Nette McIntosh, DO
Title
Regional Office Manager
Phone
(425) 396-1011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DE00008547 WA Primary

Addresses

Primary practice location

2150 112TH Ave NE Ste a
Bellevue, WA 98004-2939

Mailing address

2150 112TH Ave NE Ste a
Bellevue, WA 98004-2939
Phone (425) 455-0784

Other names 1

  • Bellevue Kids Dentist Doing business as

National Provider Directory

National Provider Directory
Part of
House Lee Mast McDonald and Nelson PC

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609286400000",
    "number": "1063657393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 112TH AVE NE STE A",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980042939",
            "telephone_number": "425-455-0784",
            "fax_number": "425-451-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 112TH AVE NE STE A",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980042939",
            "telephone_number": "425-455-0784",
            "fax_number": "425-451-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSE, LEE, MAST, MCDONALD AND NELSON, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOUSE, LEE, MAST, MCDONALD AND NELSON, PC",
        "enumeration_date": "2008-12-16",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A",
        "authorized_official_last_name": "MCINTOSH",
        "authorized_official_first_name": "LA NETTE",
        "authorized_official_title_or_position": "REGIONAL OFFICE MANAGER",
        "authorized_official_telephone_number": "425-396-1011",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00008547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bellevue Kids Dentist",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bellevue Kids Dentist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 30, 2020; 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.