Individual provider Active NPI

Lana Nysse, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Spokane Valley, WA
National Provider Identifier
1396043014
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
60824167 Issued in WA
Practice address
9019 E Mission Ave
Spokane Valley, WA 99212-2534
Phone
(855) 433-6825
NPI assigned
Mar 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 60824167 WA Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X D-5446-OR ID
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 10490 CO

Addresses

Primary practice location

9019 E Mission Ave
Spokane Valley, WA 99212-2534

Mailing address

6950 NE Campus Way
Hillsboro, OR 97124-5611
Phone (855) 433-6825

Other practice location 1

943 W Ironwood Dr Ste 200
Coeur D Alene, ID 83814-4925
Phone (855) 433-6825

Other practice location 2

1646 S Grand Ave
Pullman, WA 99163-4906
Phone (855) 433-6825

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180404002654 WA Order and Referring Only - DentistPractitioner - Dentist 0143583195

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10490COMDOrthodontics and Dentofacial Orthopedic Dentist
60824167WAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Willamette Dental Group, P.C. Past Accepting new patients
Willamette Dental Group, P.C. Past Accepting new patients

Organizations & group practices 2

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": "1299110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1396043014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6950 NE CAMPUS WAY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245611",
            "telephone_number": "855-433-6825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9019 E MISSION AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992122534",
            "telephone_number": "855-433-6825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "943 W Ironwood Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838144925",
            "country_code": "US",
            "telephone_number": "855-433-6825",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1646 S Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Pullman",
            "state": "WA",
            "postal_code": "991634906",
            "country_code": "US",
            "telephone_number": "855-433-6825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NYSSE",
        "first_name": "LANA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-03",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "60824167",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "ID",
            "license": "D-5446-OR",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "10490",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

Verify at the official NPI Registry.