Active NPI
Reza Nabaie, DDS
- Dentist
- Edmonds, WA
National Provider Identifier
1326133133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8781
- Practice address
- 21810 76TH Ave W
Suite 101
Edmonds, WA 98026-7917 - Phone
- (425) 774-3710
- Fax
- (425) 774-3311
- NPI assigned
- Oct 4, 2006
- Last updated
- Jul 9, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8781 | WA | Primary |
Addresses
Primary practice location
21810 76TH Ave W
Suite 101
Edmonds, WA 98026-7917
Mailing address
20410 27TH Ave SE
Bothell, WA 98012-3609
Phone (206) 713-3512
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150721002156 | WA | Order and Referring Only - Oral Surgery | 0042523912 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8781 | WA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Dental Center, Inc | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1326133133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20410 27TH AVE SE",
"city": "BOTHELL",
"state": "WA",
"postal_code": "980123609",
"telephone_number": "206-713-3512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21810 76TH AVE W",
"address_2": "SUITE 101",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980267917",
"telephone_number": "425-774-3710",
"fax_number": "425-774-3311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NABAIE",
"first_name": "REZA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "8781",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Edmonds, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.