Michael Conway DDS PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7496 Issued in WA

Legal business name

MICHAEL CONWAY DDS PLLC

Practice address

5723 NE Bothell Way Ste B
Kenmore, WA 98028-9404

Phone

(425) 485-0588

Fax

(425) 483-6189

NPI assigned

Jan 26, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Teri Anne Shackelford

Title

Office Manger

Phone

(425) 485-0588

Specialties & licenses 1

Addresses

Other names 1

• Kenmore Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Joseph Conway, D.D.S.

  • General Practice Dentistry
  • Kenmore, WA
  • NPI 1912004037
  NPD (past)

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469059200000",
    "number": "1366748105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5723 NE BOTHELL WAY STE B",
            "city": "KENMORE",
            "state": "WA",
            "postal_code": "980289404",
            "telephone_number": "425-485-0588",
            "fax_number": "425-483-6189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5723 NE BOTHELL WAY STE B",
            "city": "KENMORE",
            "state": "WA",
            "postal_code": "980289404",
            "telephone_number": "425-485-0588",
            "fax_number": "425-483-6189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL CONWAY DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-26",
        "last_updated": "2016-07-21",
        "status": "A",
        "authorized_official_last_name": "SHACKELFORD",
        "authorized_official_first_name": "TERI",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OFFICE MANGER",
        "authorized_official_telephone_number": "425-485-0588",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "7496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kenmore Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Annie Carlton McLaulin, LMP, CD, CLC
• Erica Lee McMahon, LMT
• Karine Melkonyan, CBT
• Mercedes Alice, Arnp, LLC
• Carol Micek
• Michael E McDade DDS
• Emelia Nevada Michaelson, NREMT
• Morgan Michaelson
• Lady-Diaesha Latiesh Middleton-Benjamin, LPN
• Joseph Midgett, DPT

• General Practice Dentistry in Kenmore, WA
• Providers in Kenmore, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; 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.