Active NPI
Michael Ly, DMD, MPH
- Dentist
- Seattle, WA
National Provider Identifier
1245076413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE61675815
- Practice address
- 1660 S Columbian Way
Seattle, WA 98108-1532 - Phone
- (206) 764-2324
- NPI assigned
- Jul 8, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE61675815 | WA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
1660 S Columbian Way
Seattle, WA 98108-1532
Mailing address
1660 S Columbian Way
Seattle, WA 98108-1532
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250917002830 | WA | Order and Referring Only - Dentist | 5597269126 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE61675815 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748563200000",
"number": "1245076413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1660 S COLUMBIAN WAY",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981081532"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1660 S COLUMBIAN WAY",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981081532",
"telephone_number": "206-764-2324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LY",
"first_name": "MICHAEL",
"credential": "DMD, MPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-07-08",
"last_updated": "2025-05-30",
"certification_date": "2025-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE61675815",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; 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.