Thomas Ray Quickstad, DDS, PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

5960 Issued in WA

Practice address

3707 Providence Point Drive SE
#E
Issaquah, WA 98029

Phone

(425) 391-1331

Fax

(425) 391-5021

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 27, 2015 through Oct 27, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dkeidek, Fernyhough, Gile, Hagel, Nov & Quickstad PLLC

  • Dentist
  • Issaquah, WA
  • NPI 1891652038
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1356449847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 PROVIDENCE POINT DRIVE SE",
            "address_2": "#E",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "98029",
            "telephone_number": "425-391-1331",
            "fax_number": "425-391-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 PROVIDENCE POINT DRIVE SE",
            "address_2": "#E",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "98029",
            "telephone_number": "425-391-1331",
            "fax_number": "425-391-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUICKSTAD",
        "first_name": "THOMAS",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "DDS, PLLC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "5960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rafael Putnam, RT/R
• Xunyi Qian
• Mary Ellen Quan, O.D.
• Quest Ketamine Therapies PLLC
• Quest Physical Therapy, LLC
• Caitlin Marie Quinn, DPT
• Jessica J. Quinn, DPT
• Andrea V Quintanares, COTA/L
• Christen A Rae, MA, BCBA, LBA
• Colin Arnold Raelson, MD

• Dentist in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.