Laura Burgett
Individual provider Active NPI General Practice Dentistry · Covington, WA
NPI 1215385877 · NPPES record last updated Sep 27, 2023
Key facts
- NPI
- 1215385877
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DE60761963 (WA)
- Practice address
- 17224 SE 272ND St
Covington, WA 98042-4953 - Phone
- (253) 630-4400
- NPI assigned
- May 24, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160817001713 | WA | Order and Referring Only - Oral Surgery |
7810282779 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Covington Family Dentistry, PLLC | General Practice | Past |
Accepting new patients |
| Peregrine Pacific Anesthesia PLLC | Past | Accepting new patients | |
| Winston & Letwin DDS, PLLC | General Practice | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | DE60761963 | WA | Yes |
Addresses
Primary practice location
17224 SE 272ND St
Covington, WA 98042-4953
Mailing address
708 E 3Rd St
Coal Valley, IL 61240-9413
Other practice location 1
4915 25th Ave NE
Suite 205
Seattle, WA 98105-5667
Phone (206) 524-1600
Other providers in Covington, WA
- Heather Bruns
- Buchanan Chiropractic, PLLC
- Glenn Alan Buchanan
- Nyrene Buford
- Ashley Marie Bullers
- Steven Kendall Burkhead
- Melanie Burnam
- Jullian R. Burton
- Callie Anne Byrd
- Maria Belen Calkins
All providers in Covington, WA · General Practice Dentistry in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.