NPIMap

Organization Active NPI

Kamal H Bajwa DDS PLLC

  • General Practice Dentistry
  • Burien, WA
National Provider Identifier
1366895377
Registry record updated Jul 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00008572 Issued in WA
Legal business name
KAMAL H BAJWA DDS PLLC
Practice address
14242 Ambaum Blvd SW
Suite 1
Burien, WA 98166-1448
Phone
(206) 242-8080
Fax
(206) 242-2339
NPI assigned
Jul 14, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2016

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

Authorized official

Name
Dr. Kamal H Bajwa, DDSNPI 1396721593
Title
Owner/Dentist
Phone
(206) 242-8080

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DE00008572 WA Primary

Addresses

Primary practice location

14242 Ambaum Blvd SW
Suite 1
Burien, WA 98166-1448

Mailing address

14242 Ambaum Blvd SW
Suite 1
Burien, WA 98166-1448
Phone (206) 242-8080

Other identifiers 1

IdentifierTypeStateIssuer
1009362MedicaidWA

Other names 1

  • New Wave Dental Smiles Doing business as

National Provider Directory

National Provider Directory

Locations

14242 Ambaum Blvd SW
Ste 1
Burien, WA 98166
Phone (206) 242-8080

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468454400000",
    "number": "1366895377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14242 AMBAUM BLVD SW",
            "address_2": "SUITE 1",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981661448",
            "telephone_number": "206-242-8080",
            "fax_number": "206-242-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14242 AMBAUM BLVD SW",
            "address_2": "SUITE 1",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981661448",
            "telephone_number": "206-242-8080",
            "fax_number": "206-242-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAMAL H BAJWA DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-14",
        "last_updated": "2016-07-14",
        "status": "A",
        "authorized_official_last_name": "BAJWA",
        "authorized_official_first_name": "KAMAL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "206-242-8080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00008572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009362",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Wave Dental Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burien, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.