Individual provider Active NPI

K Ben Skerbeck, DDS

  • General Practice Dentistry
  • Port Angeles, WA
National Provider Identifier
1194830893
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00006393 Issued in WA
Practice address
218 South Laurel
Port Angeles, WA 98362
Phone
(360) 452-3808
Fax
(360) 452-6887
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE00006393 WA Primary

Addresses

Primary practice location

218 South Laurel
Port Angeles, WA 98362

Mailing address

218 South Laurel
Port Angeles, WA 98362
Phone (360) 452-3808

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
I20180322002893 WA Order and Referring Only - DentistPractitioner - Dentist 6709061757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
K Ben Skerback Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194830893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 SOUTH LAUREL",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "98362",
            "telephone_number": "360-452-3808",
            "fax_number": "360-452-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 SOUTH LAUREL",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "98362",
            "telephone_number": "360-452-3808",
            "fax_number": "360-452-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKERBECK",
        "first_name": "K",
        "middle_name": "BEN",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00006393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

Verify at the official NPI Registry.