Nicholas Maniatis, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DE61239837 Issued in WA

Practice address

19365 7TH Ave NE Ste 110
Poulsbo, WA 98370-7441

Phone

(360) 697-3331

NPI assigned

Mar 15, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nicholas Maniatis DMD PLLC

  • General Practice Dentistry
  • Seattle, WA
  • NPI 1891574521
  NPD Authorized official
• Scott a. Broadbent, D.D.S, P.S.

  • General Practice Dentistry
  • Poulsbo, WA
  • NPI 1699873844
  NPD (past)

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1265017867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19365 7TH AVE NE STE 110",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707441",
            "telephone_number": "360-697-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19365 7TH AVE NE STE 110",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707441",
            "telephone_number": "360-697-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANIATIS",
        "first_name": "NICHOLAS",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-15",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61239837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Cecile Macdonald, DO, FAAP
• Margaret Mackay, DPT
• Berit L Madsen, MD
• Emily Grace Magwire, FNP
• Marie Maldonado Robert
• Susan Lynn Marra, ND
• Martha & Mary Home and Community Services
• Martha and Mary Health Services
• Martha and Mary Lutheran Services
• Nicholas Martinez

• Dentist in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; 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.

Verify at the official NPI Registry.