Active NPI
Daniel Thomas Brady, DDS
- Oral and Maxillofacial Surgery (Dentist)
- Arlington, WA
National Provider Identifier
1376725499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- DE 60214391
- Practice address
- 16410 Smokey Point Blvd
Suite 103
Arlington, WA 98223-8415 - Phone
- (360) 658-8822
- Fax
- (360) 659-1275
- NPI assigned
- Nov 30, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | DE 60214391 | WA | Primary |
Addresses
Primary practice location
16410 Smokey Point Blvd
Suite 103
Arlington, WA 98223-8415
Mailing address
11705 Wilmington Way
Mukilteo, WA 98275-6012
Phone (425) 953-6476
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 9, 2012 through May 9, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE 60214391 | WA | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kincaid, McClary & Kim D.D.S, P.S. | Oral and Maxillofacial Surgery | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Oral and Maxillofacial Surgery (Dentist)
- Arlington, WA
- NPI 1043267925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330905600000",
"number": "1376725499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11705 WILMINGTON WAY",
"city": "MUKILTEO",
"state": "WA",
"postal_code": "982756012",
"telephone_number": "425-953-6476",
"fax_number": "360-659-1275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16410 SMOKEY POINT BLVD",
"address_2": "SUITE 103",
"city": "ARLINGTON",
"state": "WA",
"postal_code": "982238415",
"telephone_number": "360-658-8822",
"fax_number": "360-659-1275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADY",
"first_name": "DANIEL",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-30",
"last_updated": "2012-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "WA",
"license": "DE 60214391",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Arlington, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.