Nicholas Docter, DDS
Individual provider Active NPI General Practice Dentistry · Mercer Island, WA
NPI 1245906916 · NPPES record last updated Aug 21, 2021
Key facts
- NPI
- 1245906916
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DE61197951 (WA)
- Practice address
- 3236 78TH Ave SE Ste 106
Mercer Island, WA 98040-3500 - Phone
- (206) 232-5866
- NPI assigned
- Aug 21, 2021
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE61197951 | WA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John C Lind DDS | General Practice | Past |
Accepting new patients |
Interoperability endpoints
- nicholas.docter.1@13902.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DE61197951 | WA | Yes |
Addresses
Primary practice location
3236 78TH Ave SE Ste 106
Mercer Island, WA 98040-3500
Mailing address
15020 66TH CT NE
Kenmore, WA 98028-4380
Phone (425) 463-8964
Other providers in Mercer Island, WA
- Dina E McNeil Arnp PLLC
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- Divorce Options, P.S.
- Dkeidek, Fernyhough, Gile, Hagel, Nov & Quickstad PLLC
- Dkeidek, Fernyhough, Gile, Hagel, Nov & Quickstad PLLC
- Dr Jeffrey Parton DC PS
- Diana Maria Dsouza
- Rebecca L Dudley
- David Louis Dunner
- Steven Bruce Dunning
All providers in Mercer Island, 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 Aug 21, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.