Individual provider Active NPI

Richard Dennis Kawamoto, DDS

  • Dentist
  • Shoreline, WA
National Provider Identifier
1114006590
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4096 Issued in WA
Practice address
727 N 182ND St
Suite 201
Shoreline, WA 98133-4402
Phone
(206) 546-2424
Fax
(206) 546-2425
NPI assigned
Nov 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4096 WA Primary

Addresses

Primary practice location

727 N 182ND St
Suite 201
Shoreline, WA 98133-4402

Mailing address

727 N 182ND St
Suite 201
Shoreline, WA 98133-4402
Phone (206) 546-2424

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

LicenseStateTypeSpecialty
4096WAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1162598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114006590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 N 182ND ST",
            "address_2": "SUITE 201",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981334402",
            "telephone_number": "206-546-2424",
            "fax_number": "206-546-2425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 N 182ND ST",
            "address_2": "SUITE 201",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981334402",
            "telephone_number": "206-546-2424",
            "fax_number": "206-546-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAWAMOTO",
        "first_name": "RICHARD",
        "middle_name": "DENNIS",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "4096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, 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.

Verify at the official NPI Registry.