Active NPI
Davinci Dental
- Dental Clinic/Center
- Bellevue, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Clinic/Center
- License
- 60555911
- Legal business name
- DAVINCI DENTAL
- Practice address
- 909 112TH Ave NE Ste P104
Davinci Dental
Bellevue, WA 98004-8589 - Phone
- (425) 409-9999
- NPI assigned
- Jun 8, 2015
- Last updated
- Jun 8, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Beau Jerome Keller, DDS
- Title
- Dentist
- Phone
- (425) 409-9999
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | 60555911 | WA | Primary |
Addresses
Primary practice location
909 112TH Ave NE Ste P104
Davinci Dental
Bellevue, WA 98004-8589
Mailing address
909 112TH Ave NE Ste P104
Davinvi Dental
Bellevue, WA 98004-8589
Phone (425) 409-9999
National Provider Directory
National Provider Directory- Tax ID family
- Da Vinci Dental LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Dentist
- Bellevue, WA
- NPI 1588856652
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433721600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1433721600000",
"number": "1366822017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 112TH AVE NE STE P104",
"address_2": "DAVINVI DENTAL",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980048589",
"telephone_number": "425-409-9999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 112TH AVE NE STE P104",
"address_2": "DAVINCI DENTAL",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980048589",
"telephone_number": "425-409-9999"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DAVINCI DENTAL",
"organizational_subpart": "NO",
"enumeration_date": "2015-06-08",
"last_updated": "2015-06-08",
"status": "A",
"authorized_official_last_name": "KELLER",
"authorized_official_first_name": "BEAU",
"authorized_official_middle_name": "JEROME",
"authorized_official_title_or_position": "DENTIST",
"authorized_official_telephone_number": "425-409-9999",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "261QD0000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Dental",
"state": "WA",
"license": "60555911",
"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 Jun 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.