Individual provider Active NPI

Grant Thomas Chyz, D.D.S.

  • Dentist
  • Seattle, WA
National Provider Identifier
1275615981
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5900 Issued in WA
Practice address
509 Olive Way Ste 1142
Seattle, WA 98101-1724
Phone
(206) 622-7642
Fax
(206) 622-2743
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5900 WA Primary

Addresses

Primary practice location

509 Olive Way Ste 1142
Seattle, WA 98101-1724

Mailing address

509 Olive Way Ste 1142
Seattle, WA 98101-1724
Phone (206) 622-7642

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150908000141 WA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1951617935

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5900WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275615981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 OLIVE WAY STE 1142",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011724",
            "telephone_number": "206-622-7642",
            "fax_number": "206-622-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 OLIVE WAY STE 1142",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011724",
            "telephone_number": "206-622-7642",
            "fax_number": "206-622-2743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHYZ",
        "first_name": "GRANT",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "5900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.