Joel Alexander, DMD
Individual provider Active NPI Dentist · Yakima, WA
NPI 1306583513 · NPPES record last updated May 18, 2022
Key facts
- NPI
- 1306583513
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 61292230 (WA)
- Practice address
- 602 E Nob Hill Blvd
Yakima, WA 98901-3534 - Phone
- (509) 248-3334
- NPI assigned
- May 18, 2022
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260312002874 | WA | Order and Referring Only - Dentist |
5193208692 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61292230 | WA | MD | Dentist |
Interoperability endpoints
- jalexander37719@yvfwc.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 61292230 | WA | Yes |
Addresses
Primary practice location
602 E Nob Hill Blvd
Yakima, WA 98901-3534
Mailing address
5102 Douglas Dr
Yakima, WA 98908-2560
Other providers in Yakima, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.