Active NPI
Jonathan Bernard Fisher, D.D.S.
- General Practice Dentistry
- Pullman, WA
National Provider Identifier
1255523700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 60146968
- Practice address
- 650 SE Bishop Blvd Ste 200
Pullman, WA 99163-5966 - Phone
- (095) 332-2366
- NPI assigned
- Aug 17, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D-4083 | ID | |
| General Practice Dentistry | 1223G0001X | 60146968 | WA | Primary |
Addresses
Primary practice location
650 SE Bishop Blvd Ste 200
Pullman, WA 99163-5966
Mailing address
650 SE Bishop Blvd Ste 200
Pullman, WA 99163-5966
Phone (509) 332-2366
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-4083 | ID | MD | General Practice Dentistry |
| 60146968 | WA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741046400000",
"number": "1255523700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 SE BISHOP BLVD STE 200",
"city": "PULLMAN",
"state": "WA",
"postal_code": "991635966",
"telephone_number": "509-332-2366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 SE BISHOP BLVD STE 200",
"city": "PULLMAN",
"state": "WA",
"postal_code": "991635966",
"telephone_number": "095-332-2366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "JONATHAN",
"middle_name": "BERNARD",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-17",
"last_updated": "2025-03-04",
"certification_date": "2025-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ID",
"license": "D-4083",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "60146968",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pullman, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.