Individual provider Active NPI

Marco Mass Pascua, DDS

  • Dentist
  • Bellingham, WA
National Provider Identifier
1184028136
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
RR60420802 Issued in WA
Practice address
220 Unity St
Bellingham, WA 98225-4429
Phone
(360) 676-6177
Fax
(360) 671-3574
NPI assigned
Oct 20, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X RR60420802 WA Primary

Addresses

Primary practice location

220 Unity St
Bellingham, WA 98225-4429

Mailing address

1616 Cornwall Ave
Ste. 205
Bellingham, WA 98225-4648
Phone (360) 676-6177

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
I20150729008314 WA Order and Referring Only - DentistPractitioner - Dentist 8729392113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RR60420802WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1413763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1184028136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 CORNWALL AVE",
            "address_2": "STE. 205",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254648",
            "telephone_number": "360-676-6177",
            "fax_number": "360-671-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 UNITY ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254429",
            "telephone_number": "360-676-6177",
            "fax_number": "360-671-3574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASS PASCUA",
        "first_name": "MARCO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-20",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "RR60420802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.