Desiree a. Fletcher DDS

Primary specialty

DentistTaxonomy code 122300000X

License

7649 Issued in WA

Legal business name

DESIREE A. FLETCHER DDS

Practice address

12737 Bel Red Rd
#150
Bellevue, WA 98005-2699

Phone

(425) 746-7410

Fax

(425) 641-3520

NPI assigned

Aug 10, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Desiree A Fletcher, DDS

Title

Owner/Dentist

Phone

(425) 746-7410

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470787200000",
    "number": "1265986947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12737 BEL RED RD",
            "address_2": "#150",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052699",
            "telephone_number": "425-746-7410",
            "fax_number": "425-641-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12737 BEL RED RD",
            "address_2": "#150",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052699",
            "telephone_number": "425-746-7410",
            "fax_number": "425-641-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESIREE A. FLETCHER DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-10",
        "last_updated": "2016-08-10",
        "status": "A",
        "authorized_official_last_name": "FLETCHER",
        "authorized_official_first_name": "DESIREE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "425-746-7410",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "7649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 2 NPI",
            "identifier": "1922021781",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anna A Desimone, L.M.P.
• Bethany J. Desimone, ATC
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• Dentist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.