Active NPI
Stephen J. Markham, D.D.S.
- Dentist
- Federal Way, WA
National Provider Identifier
1265420194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE00011088
- Practice address
- 720 S 320TH St Ste I
Federal Way, WA 98003-5254 - Phone
- (253) 839-5953
- NPI assigned
- Oct 13, 2005
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DD1803 | NM | |
| Dentist | 122300000X | DE00011088 | WA | Primary |
Addresses
Primary practice location
720 S 320TH St Ste I
Federal Way, WA 98003-5254
Mailing address
3305 S 255TH St Ste B
Kent, WA 98032-5660
Phone (575) 288-5172
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 94827532 | Medicaid | NM |
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 |
|---|---|---|---|
| DD1803 | NM | MD | Dentist |
| DE00011088 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699920000000",
"number": "1265420194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3305 S 255TH ST STE B",
"city": "KENT",
"state": "WA",
"postal_code": "980325660",
"telephone_number": "575-288-5172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 S 320TH ST STE I",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980035254",
"telephone_number": "253-839-5953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARKHAM",
"first_name": "STEPHEN",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-13",
"last_updated": "2023-11-14",
"certification_date": "2023-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NM",
"license": "DD1803",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE00011088",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "94827532",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Federal Way, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.