Individual provider Active NPI

Sonia Kim Takasaki, DMD

  • General Practice Dentistry
  • Seattle, WA
National Provider Identifier
1124368550
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE60634998 Issued in WA
Practice address
9730 3Rd Ave NE Ste 204
Seattle, WA 98115-2023
Phone
(206) 524-5700
Fax
(206) 524-0675
NPI assigned
Feb 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

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 DE60634998 WA Primary

Addresses

Primary practice location

9730 3Rd Ave NE Ste 204
Seattle, WA 98115-2023

Mailing address

9730 3Rd Ave NE Ste 204
Seattle, WA 98115-2023
Phone (206) 524-5700

Other names 1

  • Sonia Jihae Kim Former name

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
DE60634998WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sonia Kim Takasaki DMD PLLC CurrentSince Dec 6, 2020 Accepting new patients
Gary L Bell DDS PS General Practice PastSince Dec 6, 2020 Accepting new patients

Locations

9730 3rd Ave NE
Ste 204
Seattle, WA 98115
Phone (206) 524-5700

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1124368550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9730 3RD AVE NE STE 204",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981152023",
            "telephone_number": "206-524-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9730 3RD AVE NE STE 204",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981152023",
            "telephone_number": "206-524-5700",
            "fax_number": "206-524-0675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKASAKI",
        "first_name": "SONIA",
        "middle_name": "KIM",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-21",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60634998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SONIA",
            "last_name": "KIM",
            "middle_name": "JIHAE",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Dec 4, 2020; 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.