Active NPI
Jeffrey Alan Hirsch, D.M.D
- General Practice Dentistry
- Bellevue, WA
National Provider Identifier
1073607776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6166
- Practice address
- 11105 Main St
Bellevue, WA 98004-6319 - Phone
- (425) 462-0756
- Fax
- (425) 688-0688
- NPI assigned
- Oct 3, 2006
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6166 | WA | Primary |
Addresses
Primary practice location
11105 Main St
Bellevue, WA 98004-6319
Mailing address
10256 SE 7TH St
Bellevue, WA 98004-6182
Phone (425) 453-0236
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00542 | Other | WA | WASHINGTON DENTAL SERVICE |
| 625617 | Other | WA | UNITED CONCORDIA NUMBER |
| 60167-1 | Other | WA | DENTAL BENEFITS NUMBER |
| H19298 | Other | WA | REGENCE NUMBER |
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 |
|---|---|---|---|
| 6166 | WA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073607776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10256 SE 7TH ST",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980046182",
"telephone_number": "425-453-0236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11105 MAIN ST",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980046319",
"telephone_number": "425-462-0756",
"fax_number": "425-688-0688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIRSCH",
"first_name": "JEFFREY",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "6166",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON DENTAL SERVICE",
"identifier": "00542",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA NUMBER",
"identifier": "625617",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL BENEFITS NUMBER",
"identifier": "60167-1",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE NUMBER",
"identifier": "H19298",
"state": "WA"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.