Victor D Immel, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6921 Issued in WA

Practice address

1514 W Yakima Ave
Yakima, WA 98902-2943

Phone

(509) 457-5387

Fax

(509) 457-6580

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Practice roles

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.

• Victor Immel, DMD, PS

  • General Practice Dentistry
  • Yakima, WA
  • NPI 1366536534
  NPD (past) Authorized official

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1215021464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 W YAKIMA AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022943",
            "telephone_number": "509-457-5387",
            "fax_number": "509-457-6580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 W YAKIMA AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022943",
            "telephone_number": "509-457-5387",
            "fax_number": "509-457-6580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMMEL",
        "first_name": "VICTOR",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "6921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "128266",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "IM1280",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSHS",
            "identifier": "5032222",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "9643",
            "identifier": "9643",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maryam Jihad Ibrahim, MD
• Miranda Ice
• Ideal Option, PLLC
• Igor Elperin DDS, PLLC
• Yesenia Iman
• Diane Sumi Inaba, R.D., C.D., C.D.E.
• Independent Medical Examiners PS
• Independent Therapy Services Inc
• Carly Mikela Ingalls, M.D.
• Laura Iniguez, FNP

• General Practice Dentistry in Yakima, WA
• Providers in Yakima, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; 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.