Individual provider Active NPI

Vicki L. Fidler, DDS

  • General Practice Dentistry
  • Seattle, WA
National Provider Identifier
1255453619
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE7468 Issued in WA
Practice address
3626 NE 45TH St
Suite 200
Seattle, WA 98105-5652
Phone
(206) 526-1437
NPI assigned
Apr 5, 2007
Sex
Female
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 DE7468 WA Primary

Addresses

Primary practice location

3626 NE 45TH St
Suite 200
Seattle, WA 98105-5652

Mailing address

3626 NE 45TH St
Suite 200
Seattle, WA 98105-5652
Phone (206) 526-1437

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
I20150528001415 WA Order and Referring Only - DentistPractitioner - Dentist 7618297912

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE7468WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Vicki Fidler DDS PS CurrentSince Jun 23, 2024 Accepting new patients
Fang Sun, DDS,PHD,PLLC General Practice PastSince Jun 8, 2025 Accepting new patients

Locations

3626 NE 45th St
Ste 200
Seattle, WA 98105
Phone (206) 526-1437

Organizations & group practices 2

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": "1175731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255453619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3626 NE 45TH ST",
            "address_2": "SUITE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981055652",
            "telephone_number": "206-526-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3626 NE 45TH ST",
            "address_2": "SUITE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981055652",
            "telephone_number": "206-526-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIDLER",
        "first_name": "VICKI",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE7468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.