Active NPI
Frank John Repanich, DDS
- General Practice Dentistry
- Bellingham, WA
National Provider Identifier
1205974672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DE00005672
- Practice address
- 2814 Flint St
Bellingham, WA 98226-4436 - Phone
- (360) 734-9928
- NPI assigned
- Feb 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DE00005672 | WA | Primary |
Addresses
Primary practice location
2814 Flint St
Bellingham, WA 98226-4436
Mailing address
2814 Flint St
Bellingham, WA 98226-4436
Phone (360) 734-9928
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5672WA | Other | WA | DELTA DENTAL PROVIDER NUM |
| 5098009 | Medicaid | WA | |
| 848596 | Other | WA | UNITED CONCORDIA PROVIDER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| DE00005672 | WA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1205974672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2814 FLINT ST",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982264436",
"telephone_number": "360-734-9928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2814 FLINT ST",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982264436",
"telephone_number": "360-734-9928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REPANICH",
"first_name": "FRANK",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-01",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "DE00005672",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA DENTAL PROVIDER NUM",
"identifier": "5672WA",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5098009",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA PROVIDER",
"identifier": "848596",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
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- Claudia Rocio Rey, M.D.
- Destiny Jade Reynolds
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.