Micah Bovenkamp, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DR61043609 Issued in WA

Practice address

6222 NE 74TH St
Seattle, WA 98115-8158

Phone

(206) 543-5800

NPI assigned

Mar 31, 2020

Last updated

Mar 31, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1134757487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6222 NE 74TH ST # 354915",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981158158",
            "telephone_number": "206-543-7906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6222 NE 74TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981158158",
            "telephone_number": "206-543-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOVENKAMP",
        "first_name": "MICAH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-31",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DR61043609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savannah Monet Bouton, LMT
• Gayle A. Bouvet, PT
• Ashley Bouzis, MD
• Laura Bovee, M.D.
• Amy G Bovenkamp, D.C.
• Angela Bovo
• Nicholas Aaron Bowden, EAMP
• Thomas Andrew Bowdle, MD, PHD
• David W Bowe, MD
• Jessica Bowe, LMP

• Pediatric Dentistry in Seattle, WA
• Providers in Seattle, WA by specialty
• Pediatric Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.