Individual provider Active NPI

Jeffrey Earl Kashner, DDS,MSD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Covington, WA
National Provider Identifier
1366472607
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DE00008021 Issued in WA
Practice address
17121 SE 270TH PL
Suite 102
Covington, WA 98042-5431
Phone
(253) 630-3331
Fax
(253) 630-6881
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DE00008021 WA Primary

Addresses

Primary practice location

17121 SE 270TH PL
Suite 102
Covington, WA 98042-5431

Mailing address

703 Bellevue Ave E
Seattle, WA 98102-6928
Phone (253) 630-3331

Other identifiers 1

IdentifierTypeStateIssuer
91111635526OtherWAKITSAP PHYSICIAN SERVICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DE00008021WAMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366472607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 BELLEVUE AVE E",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981026928",
            "telephone_number": "253-630-3331",
            "fax_number": "253-630-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17121 SE 270TH PL",
            "address_2": "SUITE 102",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980425431",
            "telephone_number": "253-630-3331",
            "fax_number": "253-630-6881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASHNER",
        "first_name": "JEFFREY",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "credential": "DDS,MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "DE00008021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KITSAP PHYSICIAN SERVICE",
            "identifier": "91111635526",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.