Active NPI
Wahid Elbahr, DMD,MDS
- Endodontics
- Mukilteo, WA
National Provider Identifier
1376769752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DE00009729
- Practice address
- 12121 Harbour Reach Dr. , Ste 210
Mukilteo, WA 98275 - Phone
- (425) 316-8484
- Fax
- (425) 338-0695
- NPI assigned
- Apr 17, 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DE00009729 | WA | Primary |
Addresses
Primary practice location
12121 Harbour Reach Dr. , Ste 210
Mukilteo, WA 98275
Mailing address
12121 Harbour Reach Dr. , Ste 210
Mukiltea, WA 98275
Phone (425) 316-8484
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE00009729 | WA | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JD Endodontics LLC | 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 and National Provider Directory roles.
-
- Dental Clinic/Center
- Mukilteo, WA
- NPI 1407725518
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444694400000",
"number": "1376769752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12121 HARBOUR REACH DR. , STE 210",
"city": "MUKILTEA",
"state": "WA",
"postal_code": "98275",
"telephone_number": "425-316-8484",
"fax_number": "425-338-0695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12121 HARBOUR REACH DR. , STE 210",
"city": "MUKILTEO",
"state": "WA",
"postal_code": "98275",
"telephone_number": "425-316-8484",
"fax_number": "425-338-0695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELBAHR",
"first_name": "WAHID",
"name_prefix": "Dr.",
"credential": "DMD,MDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-17",
"last_updated": "2015-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "WA",
"license": "DE00009729",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mukilteo, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.