Individual provider Active NPI

Leah D Worstman, DDS, PLLC

  • General Practice Dentistry
  • Seattle, WA
National Provider Identifier
1164586178
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00007286 Issued in WA
Practice address
11011 Meridian Ave N
Suite 301
Seattle, WA 98133-8967
Phone
(206) 524-1000
Fax
(206) 524-0877
NPI assigned
Dec 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 DE00007286 WA Primary

Addresses

Primary practice location

11011 Meridian Ave N
Suite 301
Seattle, WA 98133-8967

Mailing address

20107 78TH Ave SE
Snohomish, WA 98296-5157
Phone (425) 481-4747

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150610001192 WA Order and Referring Only - DentistPractitioner - Dentist 9537480975

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE00007286WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Spencer Face DDS PLLC Past Accepting new patients
Christopher Pickel DDS PS Past 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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164586178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20107 78TH AVE SE",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982965157",
            "telephone_number": "425-481-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11011 MERIDIAN AVE N",
            "address_2": "SUITE 301",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338967",
            "telephone_number": "206-524-1000",
            "fax_number": "206-524-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORSTMAN",
        "first_name": "LEAH",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS, PLLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00007286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.