NPIMap

Organization Active NPI

Orthodontic Associates of Mercer Island

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Mercer Island, WA
National Provider Identifier
1083714877
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
3254 Issued in WA
Legal business name
ORTHODONTIC ASSOCIATES OF MERCER ISLAND
Practice address
2817 80TH Avenue SE
Mercer Island, WA 98040-2913
Phone
(206) 232-9600
Fax
(206) 232-2936
NPI assigned
Sep 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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

Authorized official

Name
Dr. Robert William McNeill, DDS, MS
Title
Owner
Phone
(206) 232-9600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 3254 WA Primary

Addresses

Primary practice location

2817 80TH Avenue SE
Mercer Island, WA 98040-2913

Mailing address

2817 80TH Avenue SE
Mercer Island, WA 98040-2913
Phone (206) 232-9600

Other identifiers 2

IdentifierTypeStateIssuer
6809OtherWALICENSE NUMBER
3254OtherWALICENSE NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Orthodontic Associates of Mercer Island2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2817 80th Ave SE
Mercer Island, WA 98040
Phone (206) 232-9600

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383523200000",
    "number": "1083714877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 80TH AVENUE SE",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980402913",
            "telephone_number": "206-232-9600",
            "fax_number": "206-232-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 80TH AVENUE SE",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980402913",
            "telephone_number": "206-232-9600",
            "fax_number": "206-232-2936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHODONTIC ASSOCIATES OF MERCER ISLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2013-11-04",
        "status": "A",
        "authorized_official_last_name": "MCNEILL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-232-9600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "3254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "6809",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "3254",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mercer Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.

Verify at the official NPI Registry.