NPIMap

Organization Active NPI

Washingtonoralmaxillofacialsurgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Everett, WA
National Provider Identifier
1184944001
Registry record updated Jun 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DE8227 Issued in WA
Legal business name
WASHINGTONORALMAXILLOFACIALSURGERY
Practice address
5929 Evergreen Way
300
Everett, WA 98203-6031
Phone
(425) 356-3000
Fax
(452) 535-6316
NPI assigned
Jun 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2010

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

Authorized official

Name
Dr. Jae Y Hong, DDSNPI 1538257308
Title
Owner
Phone
(425) 356-3000

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
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223S0112X DE8227 WA Primary

Addresses

Primary practice location

5929 Evergreen Way
300
Everett, WA 98203-6031

Mailing address

5929 Evergreen Way
300
Everett, WA 98203-6031
Phone (425) 356-3000

Other identifiers 1

IdentifierTypeStateIssuer
5044888MedicaidWA

National Provider Directory

National Provider Directory

Locations

5929 Evergreen Way
Ste 300
Everett, WA 98203
Phone (425) 356-3000

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275436800000",
    "number": "1184944001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5929 EVERGREEN WAY",
            "address_2": "300",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036031",
            "telephone_number": "425-356-3000",
            "fax_number": "452-535-6316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5929 EVERGREEN WAY",
            "address_2": "300",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036031",
            "telephone_number": "425-356-3000",
            "fax_number": "452-535-6316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTONORALMAXILLOFACIALSURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-02",
        "last_updated": "2010-06-02",
        "status": "A",
        "authorized_official_last_name": "HONG",
        "authorized_official_first_name": "JAE",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-356-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE8227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5044888",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; 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.