Individual provider Active NPI

Anastasiya Dovzhenko

  • Dentist
  • Snoqualmie, WA
National Provider Identifier
1194300624
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE61234931 Issued in WA
Practice address
7713 Center Blvd SE Ste 240
Snoqualmie, WA 98065-6311
Phone
(425) 292-0109
NPI assigned
Mar 16, 2021
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE61234931 WA Primary

Addresses

Primary practice location

7713 Center Blvd SE Ste 240
Snoqualmie, WA 98065-6311

Mailing address

4165 129TH PL SE Apt B102
Bellevue, WA 98006-1380
Phone (801) 712-7021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DE61234931WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Anastasiya Dovzhenko DMD PLLC CurrentSince Aug 17, 2025 Accepting new patients
Abundant Dental Care, P.C. Dentist PastSince Oct 1, 2022 Accepting new patients

Locations

7713 Center Blvd SE
Ste 240
Snoqualmie, WA 98065
Phone (425) 292-0109

Organizations & group practices 2

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": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1194300624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4165 129TH PL SE APT B102",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061380",
            "telephone_number": "801-712-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7713 CENTER BLVD SE STE 240",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980656311",
            "telephone_number": "425-292-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOVZHENKO",
        "first_name": "ANASTASIYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-16",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61234931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snoqualmie, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.