Active NPI
Jeffrey Abolofia, DDS
- General Practice Dentistry
- Burien, WA
National Provider Identifier
1386629657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DE00004593
- Practice address
- 207 SW 156TH St
Burien, WA 98166-2561 - Phone
- (206) 243-3400
- Fax
- (206) 243-3442
- NPI assigned
- Dec 9, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DE00004593 | WA | Primary |
Addresses
Primary practice location
207 SW 156TH St
Burien, WA 98166-2561
Mailing address
207 SW 156TH St
Burien, WA 98166-2561
Phone (206) 243-3400
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 |
|---|---|---|---|---|
| I20150709002059 | WA | Order and Referring Only - Dentist | 9537471156 |
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": "1134086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436227200000",
"number": "1386629657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 SW 156TH ST",
"city": "BURIEN",
"state": "WA",
"postal_code": "981662561",
"telephone_number": "206-243-3400",
"fax_number": "206-243-3442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 SW 156TH ST",
"city": "BURIEN",
"state": "WA",
"postal_code": "981662561",
"telephone_number": "206-243-3400",
"fax_number": "206-243-3442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABOLOFIA",
"first_name": "JEFFREY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-09",
"last_updated": "2015-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "DE00004593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 7, 2015; 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.