Organization Active NPI

Dentologie, PC

  • General Practice Dentistry
  • Seattle, WA
National Provider Identifier
1104742642
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTOLOGIE, PC
Practice address
1836 NW Market St
Seattle, WA 98107-3908
Phone
(206) 586-8442
NPI assigned
Jun 29, 2026
Organization subpart
Yes
Parent organization
DENTOLOGIE, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Authorized official

Name
Mr. Kenneth Neil Sullivan
Title
Director, RCM
Phone
(615) 707-0786

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1836 NW Market St
Seattle, WA 98107-3908

Mailing address

1259 S Wabash Ave
Chicago, IL 60605-2412
Phone (312) 846-6752

National Provider Directory

National Provider Directory
Tax ID family
Dentologie PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

1259 S Wabash Ave
Chicago, IL 60605
Phone (248) 563-5085

1836 NW Market St
Seattle, WA 98107
Phone (206) 260-1217

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": "1782691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782691200000",
    "number": "1104742642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1259 S WABASH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052412",
            "telephone_number": "312-846-6752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 NW MARKET ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981073908",
            "telephone_number": "206-586-8442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTOLOGIE, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTOLOGIE, PC",
        "enumeration_date": "2026-06-29",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "NEIL",
        "authorized_official_title_or_position": "DIRECTOR, RCM",
        "authorized_official_telephone_number": "615-707-0786",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; 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.