Krissa Anne Mickelwait, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DE 60363231 Issued in WA

Practice address

220 Unity St
Bellingham, WA 98225-4429

Phone

(360) 676-6177

NPI assigned

May 7, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444262400000",
    "number": "1205271970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14206 COVE CT",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982328589",
            "telephone_number": "360-708-7664"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKELWAIT",
        "first_name": "KRISSA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-07",
        "last_updated": "2015-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE 60363231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael H Crowley DDS PS
• Michael Shoff P.L.L.C.
• Libby Michel, LMHC, SUDP
• Barbara Michelson-Harder, BCHN
• Lori Savitt Michelson, MSW, LICSW
• Hiwot Soboksa Mideksa
• Masayoshi Migita, ATC, CSCS
• Angela Michelle Mikeska, OT
• Carolyn O. Miklavic, PT
• Penny Milczewski

• Dentist in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.