Individual provider Active NPI

Lauren Kersjes, DMD

  • Dentist
  • Wenatchee, WA
National Provider Identifier
1225522972
Registry record updated Jul 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE61021787 Issued in WA
Practice address
1008 5TH St
Wenatchee, WA 98801-1823
Phone
(509) 662-8815
NPI assigned
Jun 17, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 13636315-9926 UT
Dentist 122300000X DE61021787 WA Primary
Dentist 122300000X 019031579 IL

Addresses

Primary practice location

1008 5TH St
Wenatchee, WA 98801-1823

Mailing address

12160 Emig Dr
Leavenworth, WA 98826-8726
Phone (616) 558-6814

Other practice location 1

8706 S 700 E Ste 100
Sandy, UT 84070-1808
Phone (801) 255-3351

Other practice location 2

7478 S Campus View Dr Ste 202
West Jordan, UT 84084-1969
Phone (385) 355-3018

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200505000810 WA Order and Referring Only - DentistPractitioner - Dentist 9931530029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019031579ILMDDentist
13636315-9926UTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Green Dental PastSince Jul 1, 2023 Accepting new patients

Networks

  • UT PPO D-SNP

Organizations & group practices 1

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": "1529193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752278400000",
    "number": "1225522972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12160 EMIG DR",
            "city": "LEAVENWORTH",
            "state": "WA",
            "postal_code": "988268726",
            "telephone_number": "616-558-6814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 5TH ST",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988011823",
            "telephone_number": "509-662-8815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8706 S 700 E Ste 100",
            "address_purpose": "LOCATION",
            "city": "Sandy",
            "state": "UT",
            "postal_code": "840701808",
            "country_code": "US",
            "telephone_number": "801-255-3351",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7478 S Campus View Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "West Jordan",
            "state": "UT",
            "postal_code": "840841969",
            "country_code": "US",
            "telephone_number": "385-355-3018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERSJES",
        "first_name": "LAUREN",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-17",
        "last_updated": "2025-07-12",
        "certification_date": "2025-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "13636315-9926",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61021787",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019031579",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

Verify at the official NPI Registry.