Organization Active NPI

Dr, Richard Bienenfeld, D.D.S.

  • Dental Clinic/Center
  • Kirkland, WA
National Provider Identifier
1104093319
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
4831 Issued in WA
Legal business name
DR, RICHARD BIENENFELD, D.D.S.
Practice address
12815 120TH Ave NE
Suite G
Kirkland, WA 98034-3003
Phone
(425) 821-9600
Fax
(425) 820-6652
NPI assigned
May 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Authorized official

Name
Mrs. Cheri Doyle
Title
Office Manager
Phone
(425) 821-9600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 4831 WA Primary

Addresses

Primary practice location

12815 120TH Ave NE
Suite G
Kirkland, WA 98034-3003

Mailing address

12815 120TH Ave NE
Suite G
Kirkland, WA 98034-3003
Phone (425) 821-9600

Other identifiers 1

IdentifierTypeStateIssuer
5501606MedicaidWA

National Provider Directory

National Provider Directory

Locations

12815 120th Ave NE
Ste G
Kirkland, WA 98034
Phone (425) 821-9600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1104093319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12815 120TH AVE NE",
            "address_2": "SUITE G",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343003",
            "telephone_number": "425-821-9600",
            "fax_number": "425-820-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12815 120TH AVE NE",
            "address_2": "SUITE G",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343003",
            "telephone_number": "425-821-9600",
            "fax_number": "425-820-6652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR, RICHARD BIENENFELD, D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "DOYLE",
        "authorized_official_first_name": "CHERI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "425-821-9600",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "4831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5501606",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.