NPIMap

Organization Active NPI

Neal C Raval DDS MSD PS Inc

  • Periodontics
  • Bellevue, WA
National Provider Identifier
1356768774
Registry record updated Mar 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DE60280931 Issued in WA
Legal business name
NEAL C RAVAL DDS MSD PS INC
Practice address
1418 112TH Ave NE
Suite 100
Bellevue, WA 98004
Phone
(425) 453-1010
Fax
(425) 637-8704
NPI assigned
Mar 24, 2014
Last updated
Mar 24, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
NEAL C RAVAL DDS MSD PS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 24, 2014

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

Authorized official

Name
Mrs. Jill Klaiber
Title
Office Manager
Phone
(425) 453-1010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DE60280931 WA Primary

Addresses

Primary practice location

1418 112TH Ave NE
Suite 100
Bellevue, WA 98004

Mailing address

1418 112TH Ave NE
Suite 100
Bellevue, WA 98004
Phone (425) 453-1010

National Provider Directory

National Provider Directory
Part of
Neal C Raval DDS MSD PS Inc

Locations

1418 112th Ave NE
Ste 100
Bellevue, WA 98004
Phone (425) 453-1010

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395619200000",
    "number": "1356768774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 112TH AVE NE",
            "address_2": "SUITE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-453-1010",
            "fax_number": "425-637-8704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 112TH AVE NE",
            "address_2": "SUITE 100",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-453-1010",
            "fax_number": "425-637-8704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEAL C RAVAL DDS MSD PS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEAL C RAVAL DDS MSD PS INC",
        "enumeration_date": "2014-03-24",
        "last_updated": "2014-03-24",
        "status": "A",
        "authorized_official_last_name": "KLAIBER",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "425-453-1010",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": "DE60280931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.