Active NPI
Vicki L. Fidler, DDS
- General Practice Dentistry
- Seattle, WA
National Provider Identifier
1255453619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DE7468
- 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
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 |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150528001415 | WA | Order and Referring Only - Dentist | 7618297912 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE7468 | WA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vicki Fidler DDS PS | Current | Accepting new patients | |
| Fang Sun, DDS,PHD,PLLC | General Practice | Past | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.