Individual provider Active NPI

Hirbod Rowshan, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Bellevue, WA
National Provider Identifier
1356325989
Registry record updated May 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DE60243710 Issued in WA
Practice address
12715 NE Bel Red Rd Ste 130
Bellevue, WA 98005-2627
Phone
(425) 454-5091
Fax
(425) 454-5330
NPI assigned
Dec 6, 2005
Last updated
May 1, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DE60243710 WA Primary

Addresses

Primary practice location

12715 NE Bel Red Rd Ste 130
Bellevue, WA 98005-2627

Mailing address

12715 NE Bel Red Rd Ste 130
Bellevue, WA 98005-2627
Phone (425) 454-5091

Other practice location 1

1800 116th Ave NE Ste 101
Bellevue, WA 98004-3043
Phone (425) 454-5091

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
I20160505001089 WA Practitioner - Oral Surgery 3173822681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Indiana University School of Dentistry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12715 Bel-Red Rd
Suite 130
Bellevue, WA 98005

12715 NE Bel Red Rd
Suite 130
Bellevue, WA 98005-2627
Phone (425) 454-5091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE60243710WAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Oral & Maxillofacial Surgery Oral and Maxillofacial Surgery CurrentSince Mar 6, 2016 Accepting new patients
Bellevue Chiropractic PS PastSince Dec 3, 2002 Accepting new patients

Locations

12715 NE Bel Red Rd
Ste 130
Bellevue, WA 98005
Phone (206) 351-2689

1800 116th Ave NE
Ste 101
Bellevue, WA 98004
Phone (425) 637-0094

Organizations & group practices 2

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": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1356325989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12715 NE BEL RED RD STE 130",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052627",
            "telephone_number": "425-454-5091",
            "fax_number": "425-454-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12715 NE BEL RED RD STE 130",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052627",
            "telephone_number": "425-454-5091",
            "fax_number": "425-454-5330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 116th Ave NE Ste 101",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980043043",
            "country_code": "US",
            "telephone_number": "425-454-5091",
            "fax_number": "425-454-5330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROWSHAN",
        "first_name": "HIRBOD",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE60243710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.