Individual provider Active NPI

Amber D. Amelang-Severin, DDS,MS

  • Endodontics
  • Bellingham, WA
National Provider Identifier
1376704718
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DE60735368 Issued in WA
Practice address
1310 Broadway Ste 1B
Bellingham, WA 98225-2953
Phone
(360) 734-4777
NPI assigned
Jun 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DE60735368 WA Primary

Addresses

Primary practice location

1310 Broadway Ste 1B
Bellingham, WA 98225-2953

Mailing address

4 Clear Lake CT
Bellingham, WA 98229-7905
Phone (970) 449-2924

Other practice location 1

130 S 15th St Ste 101
Mount Vernon, WA 98274-4569
Phone (360) 428-4393

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DE60735368WAMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew Eric Carlson, DDS, PLLC Endodontics CurrentSince Jun 9, 2024 Accepting new patients

Locations

1310 Broadway
Ste 1B
Bellingham, WA 98225
Phone (360) 734-4777

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1376704718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CLEAR LAKE CT",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982297905",
            "telephone_number": "970-449-2924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 BROADWAY STE 1B",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982252953",
            "telephone_number": "360-734-4777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 S 15th St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982744569",
            "country_code": "US",
            "telephone_number": "360-428-4393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMELANG-SEVERIN",
        "first_name": "AMBER",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "DDS,MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-18",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "DE60735368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.