Individual provider Active NPI

Jack Batjer, DDS

  • General Practice Dentistry
  • Tacoma, WA
National Provider Identifier
1245385228
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE9406 Issued in WA
Practice address
1919 N Pearl St Ste A1
Tacoma, WA 98406-2456
Phone
(253) 756-2100
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE9406 WA Primary

Addresses

Primary practice location

1919 N Pearl St Ste A1
Tacoma, WA 98406-2456

Mailing address

1919 N Pearl St Ste A1
Tacoma, WA 98406-2456
Phone (253) 756-2100

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
I20160706002004 WA Order and Referring Only - DentistPractitioner - Dentist 0749572014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE9406WAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245385228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 N PEARL ST STE A1",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984062456",
            "telephone_number": "253-756-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 N PEARL ST STE A1",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984062456",
            "telephone_number": "253-756-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATJER",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE9406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.