Individual provider Active NPI

Jessica Kowalczyk

  • General Practice Dentistry
  • Wenatchee, WA
National Provider Identifier
1134040405
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
70133357 Issued in WA
Practice address
214 2ND St
Wenatchee, WA 98801-2197
Phone
(509) 663-4709
NPI assigned
Jul 23, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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 70133357 WA Primary

Addresses

Primary practice location

214 2ND St
Wenatchee, WA 98801-2197

Mailing address

5342 S Newland Ave
Chicago, IL 60638-1127

Other practice location 1

746 F St SW
Quincy, WA 98848-1370
Phone (509) 787-1507

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

Practice roles

OrganizationSpecialtyStatusNew patients
Phillip E Harrison DDS PS Past Accepting new patients
Paul Y Kwon, DDS, PLLC PastSince Jun 23, 2025 Accepting new patients

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": "1784764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1134040405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5342 S NEWLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606381127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 2ND ST",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012197",
            "telephone_number": "509-663-4709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "746 F St SW",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "WA",
            "postal_code": "988481370",
            "country_code": "US",
            "telephone_number": "509-787-1507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOWALCZYK",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-23",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "70133357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; 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.