Adam Pristera, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DE 60586504 Issued in WA

Practice address

350 S 38TH CT Ste 215
Renton, WA 98055-5777

Phone

(425) 430-1320

Fax

(425) 430-1319

NPI assigned

May 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441670400000",
    "number": "1114139599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 S 38TH CT STE 215",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555777",
            "telephone_number": "425-430-1320",
            "fax_number": "425-430-1319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S 38TH CT STE 215",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555777",
            "telephone_number": "425-430-1320",
            "fax_number": "425-430-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRISTERA",
        "first_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-05",
        "last_updated": "2015-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "053094",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "009648",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "DE 60586504",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "DE 60586504",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nivea Prietol Mayfield
• Neenah Marie Primas
• Prime Care PLLC
• Prime Pharmacy Corp
• Prisma Wellness, PLLC
• Pristine House Renton LLC
• Mandy M Pritchard, MPT
• Progressive Psychological Behavioral Health Services, LLC
• Proliance Surgeons Inc P S
• Proliance Surgeons Inc P S

• Orthodontics and Dentofacial Orthopedics Dentistry in Renton, WA
• Providers in Renton, WA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; 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.