Individual provider Active NPI

Michael Manchang Siew Jr., DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Seattle, WA
National Provider Identifier
1164959169
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
70011270 Issued in WA
Practice address
916 NE Ravenna Blvd
Seattle, WA 98115-5566
Phone
(206) 845-7333
Fax
(206) 672-1369
NPI assigned
May 22, 2017
Last updated
Aug 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 37666 TX
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 70011270 WA
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 37666 TX
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 70011270 WA Primary

Addresses

Primary practice location

916 NE Ravenna Blvd
Seattle, WA 98115-5566

Mailing address

916 NE Ravenna Blvd
Seattle, WA 98115-5566
Phone (206) 845-7333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20241210001690 TX Practitioner - Oral SurgeryPractitioner - Dentist 0143756403 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37666TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Umc El Paso Healthcare Inc Oral and Maxillofacial Surgery CurrentSince Oct 27, 2024 Accepting new patients
West Texas Maxillofacial Surgery PA Oral & Maxillofacial Surgery CurrentSince Apr 14, 2024 Accepting new patients
Michael M Siew DDS MD PLLC Oral and Maxillofacial Surgery Past Accepting new patients

Locations

10175 Gateway Blvd W
Ste 304
El Paso, TX 79925
Phone (915) 504-6880

4500 N Mesa St
El Paso, TX 79912
Phone (915) 532-9000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24611/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1164959169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 NE RAVENNA BLVD",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981155566",
            "telephone_number": "206-845-7333",
            "fax_number": "206-672-1369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 NE RAVENNA BLVD",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981155566",
            "telephone_number": "206-845-7333",
            "fax_number": "206-672-1369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEW",
        "first_name": "MICHAEL",
        "middle_name": "MANCHANG",
        "name_suffix": "Jr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-22",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "37666",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "WA",
            "license": "70011270",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TX",
            "license": "37666",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "70011270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.