Individual provider Active NPI

Padmaraj (Raj) V. Angolkar, D.D.S., M.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Tukwila, WA
National Provider Identifier
1205906203
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DE00005781 Issued in WA
Practice address
13530 53Rd Ave S Ste 100
Tukwila, WA 98168-4784
Phone
(206) 246-9656
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DE00005781 WA Primary

Addresses

Primary practice location

13530 53Rd Ave S Ste 100
Tukwila, WA 98168-4784

Mailing address

13530 53Rd Ave S Ste 100
Tukwila, WA 98168-4784
Phone (206) 246-9656

Other practice location 1

13346 1st Ave NE
Seattle, WA 98125-3036
Phone (206) 523-6327

Other identifiers 2

IdentifierTypeStateIssuer
1316148018MedicaidWA
1700087111MedicaidWA

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
DE00005781WAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
M. K. Ahmed, D.D.S., M.S., PLLC Orthodontics and Dentofacial Orthopedics CurrentSince Mar 24, 2024 Accepting new patients
Tripti Pawar BDS MSD PLLC PastSince Jan 19, 2022 Accepting new patients
Padmaraj V. Angolkar D.D.S., M.D.S. Orthodontics and Dentofacial Orthopedics Past Accepting new patients
Padmaraj V. Angolkar D.D.S., M.D.S. Orthodontics and Dentofacial Orthopedics PastSince Mar 24, 2024 Accepting new patients

Locations

13346 1st Ave NE
Seattle, WA 98125
Phone (206) 361-2602

13530 53rd Ave S
Ste 100
Tukwila, WA 98168
Phone (206) 246-9656

Organizations & group practices 4

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1205906203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13530 53RD AVE S STE 100",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981684784",
            "telephone_number": "206-246-9656",
            "fax_number": "425-392-0671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13530 53RD AVE S STE 100",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981684784",
            "telephone_number": "206-246-9656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13346 1st Ave NE",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981253036",
            "country_code": "US",
            "telephone_number": "206-523-6327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANGOLKAR",
        "first_name": "PADMARAJ (RAJ)",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "DE00005781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316148018",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700087111",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tukwila, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; 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.