Organization Active NPI

Teeth R US

  • Dentist
  • Bothell, WA
National Provider Identifier
1124426846
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7078 Issued in WA
Legal business name
TEETH R US
Practice address
1908 201 PL SE Suite #201
Bothell, WA 98012
Phone
(425) 892-9096
NPI assigned
Dec 11, 2014
Organization subpart
Yes
Parent organization
TEETH R US LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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

Authorized official

Name
David Myaskovsky
Title
DDS Owner
Phone
(425) 892-9096

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 7078 WA Primary

Addresses

Primary practice location

1908 201 PL SE Suite #201
Bothell, WA 98012

Mailing address

1908 201 PL SE Suite #201
Bothell, WA 98012
Phone (425) 892-9096

National Provider Directory

National Provider Directory
Part of
Teeth R US

NPI Registry JSON

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

{
    "created_epoch": "1418256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418256000000",
    "number": "1124426846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 201 PL SE SUITE #201",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "98012",
            "telephone_number": "425-892-9096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 201 PL SE SUITE #201",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "98012",
            "telephone_number": "425-892-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEETH R US",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TEETH R US LLC",
        "enumeration_date": "2014-12-11",
        "last_updated": "2014-12-11",
        "status": "A",
        "authorized_official_last_name": "MYASKOVSKY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DDS OWNER",
        "authorized_official_telephone_number": "425-892-9096"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "7078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2014; 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.