Active NPI
Joao Vicente Baroni Barbizam, DDS, MSD
- Dentist
- Everett, WA
National Provider Identifier
1063849883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE60363990
- Practice address
- 10025 19TH Ave SE
Suite 202
Everett, WA 98208-4275 - Phone
- (425) 357-8747
- NPI assigned
- Oct 11, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 | DE60363990 | WA | Primary |
Addresses
Primary practice location
10025 19TH Ave SE
Suite 202
Everett, WA 98208-4275
Mailing address
5114 26TH Ave NE
Seattle, WA 98105-3102
Phone (206) 913-3936
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
| License | State | Type | Specialty |
|---|---|---|---|
| DE60363990 | WA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeside Endodontics | 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.
-
- Endodontics
- Everett, WA
- NPI 1104056910
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381449600000",
"number": "1063849883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5114 26TH AVE NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981053102",
"telephone_number": "206-913-3936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10025 19TH AVE SE",
"address_2": "SUITE 202",
"city": "EVERETT",
"state": "WA",
"postal_code": "982084275",
"telephone_number": "425-357-8747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARBIZAM",
"first_name": "JOAO",
"middle_name": "VICENTE BARONI",
"credential": "DDS, MSD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-10-11",
"last_updated": "2013-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE60363990",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.