NPIMap

Organization Active NPI

Northwest Dental Center, Inc

Doing business as Northwest Dental Center

  • Dentist
  • Edmonds, WA
National Provider Identifier
1174968507
Registry record updated Apr 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE8781 Issued in WA
Legal business name
NORTHWEST DENTAL CENTER, INC
Doing business as
Northwest Dental Center
Practice address
21810 76TH Ave W
101
Edmonds, WA 98026-7917
Phone
(425) 774-3710
Fax
(425) 774-3311
NPI assigned
Apr 29, 2013
Last updated
Apr 29, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2013

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

Authorized official

Name
Dr. Reza Nabaie, D.D.S.NPI 1326133133
Title
President
Phone
(425) 774-3710

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE8781 WA Primary

Addresses

Primary practice location

21810 76TH Ave W
101
Edmonds, WA 98026-7917

Mailing address

21810 76TH Ave W
101
Edmonds, WA 98026-7917
Phone (425) 774-3710

Other names 1

  • Northwest Dental Center Doing business as

National Provider Directory

National Provider Directory

Locations

21810 76th Ave W
Ste 101
Edmonds, WA 98026
Phone (425) 774-3710

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367193600000",
    "number": "1174968507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21810 76TH AVE W",
            "address_2": "101",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267917",
            "telephone_number": "425-774-3710",
            "fax_number": "425-774-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21810 76TH AVE W",
            "address_2": "101",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267917",
            "telephone_number": "425-774-3710",
            "fax_number": "425-774-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST DENTAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-29",
        "last_updated": "2013-04-29",
        "status": "A",
        "authorized_official_last_name": "NABAIE",
        "authorized_official_first_name": "REZA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-774-3710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE8781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; 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.