Individual provider Active NPI

Chelsea D'Nichole Mortell, DMD

  • General Practice Dentistry
  • Kirkland, WA
National Provider Identifier
1114272697
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE60287180 Issued in WA
Practice address
13131 120TH Ave NE
Kirkland, WA 98034-3037
Phone
(425) 821-3834
NPI assigned
Jul 19, 2012
Last updated
Jul 19, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE60287180 WA Primary

Addresses

Primary practice location

13131 120TH Ave NE
Kirkland, WA 98034-3037

Mailing address

10922 SE 10TH PL
Bellevue, WA 98004-6825
Phone (425) 753-3622

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
DE60287180WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Consolidated Dental LLC General Practice Current Accepting new patients
Consolidated Dental Two Current Accepting new patients
Consolidated Dental Three Current Accepting new patients

Locations

13611 100th Ave NE
Kirkland, WA 98034
Phone (425) 380-4661

13611 100th Ave NE
Ste 102
Kirkland, WA 98034

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1342656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342656000000",
    "number": "1114272697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10922 SE 10TH PL",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046825",
            "telephone_number": "425-753-3622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13131 120TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343037",
            "telephone_number": "425-821-3834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTELL",
        "first_name": "CHELSEA",
        "middle_name": "D'NICHOLE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-19",
        "last_updated": "2012-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60287180",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 19, 2012; 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.