Active NPI
Nicholas Andrew Raklios, D.D.S.
- Pediatric Dentistry
- Lynnwood, WA
National Provider Identifier
1235510512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DE.60557938
- Practice address
- 16006 Ash Way
Ste 103
Lynnwood, WA 98087-6352 - Phone
- (425) 301-2270
- NPI assigned
- Jun 12, 2015
- Last updated
- Jun 12, 2015
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DE.60557938 | WA | Primary |
Addresses
Primary practice location
16006 Ash Way
Ste 103
Lynnwood, WA 98087-6352
Mailing address
16006 Ash Way
Ste 103
Lynnwood, WA 98087-6352
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 |
|---|---|---|---|
| DE.60557938 | WA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nicholas Raklios, DDS, PLLC | Pediatric Dentistry | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1434067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434067200000",
"number": "1235510512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16006 ASH WAY",
"address_2": "STE 103",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980876352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16006 ASH WAY",
"address_2": "STE 103",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980876352",
"telephone_number": "425-301-2270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAKLIOS",
"first_name": "NICHOLAS",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-12",
"last_updated": "2015-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "WA",
"license": "DE.60557938",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.