Individual provider Active NPI

Sonya R Whisler, D.D.S.

  • Dentist
  • Lacey, WA
National Provider Identifier
1164700332
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE.60223228 Issued in WA
Practice address
1607 Ruddell Rd SE
Lacey, WA 98503
Phone
(360) 459-1600
Fax
(360) 459-1604
NPI assigned
Jul 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE.60223228 WA Primary

Addresses

Primary practice location

1607 Ruddell Rd SE
Lacey, WA 98503

Mailing address

1607 Ruddell Rd SE
Lacey, WA 98503-2757
Phone (360) 459-1600

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
I20160509001931 WA Order and Referring Only - DentistPractitioner - Dentist 4385943661

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE.60223228WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ruddell Road Dental Center Past Accepting new patients

Organizations & group practices 1

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": "1311292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1164700332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 RUDDELL RD SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985032757",
            "telephone_number": "360-459-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 RUDDELL RD SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "98503",
            "telephone_number": "360-459-1600",
            "fax_number": "360-459-1604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHISLER",
        "first_name": "SONYA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-22",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE.60223228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

Verify at the official NPI Registry.