Individual provider Active NPI

Reza Nabaie, DDS

  • Dentist
  • Edmonds, WA
National Provider Identifier
1326133133
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8781 Issued in WA
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, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150721002156 WA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0042523912

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8781WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew 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

Verify at the official NPI Registry.