Active NPI
Pallavi Golani
- Dentist
- Lynnwood, WA
National Provider Identifier
1386154359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE60792632
- Practice address
- 4111 194TH St SW
Lynnwood, WA 98036-4604 - Phone
- (425) 551-1000
- NPI assigned
- Oct 4, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DE60792632 | WA | Primary |
Addresses
Primary practice location
4111 194TH St SW
Lynnwood, WA 98036-4604
Mailing address
1424 Broadway
Everett, WA 98201-1720
Other practice location 1
1426 Fowler St
Richland, WA 99352-4717
Phone (509) 371-1160
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180925000869 | WA | Order and Referring Only - Dentist | 3072864479 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726790400000",
"number": "1386154359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1424 BROADWAY",
"city": "EVERETT",
"state": "WA",
"postal_code": "982011720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4111 194TH ST SW",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980364604",
"telephone_number": "425-551-1000"
}
],
"practiceLocations": [
{
"address_1": "1426 Fowler St",
"address_purpose": "LOCATION",
"city": "Richland",
"state": "WA",
"postal_code": "993524717",
"country_code": "US",
"telephone_number": "509-371-1160",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOLANI",
"first_name": "PALLAVI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-04",
"last_updated": "2024-09-20",
"certification_date": "2024-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE60792632",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.