NPIMap

Organization Active NPI

NW Family Dental

  • General Practice Dentistry
  • Redmond, WA
National Provider Identifier
1407172406
Registry record updated Apr 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
603-005-065 Issued in WA
Legal business name
NW FAMILY DENTAL
Practice address
15955 NE 85TH St
Ste 101
Redmond, WA 98052-3550
Phone
(425) 883-2933
Fax
(425) 885-0146
NPI assigned
Apr 15, 2010
Last updated
Apr 16, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2010

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

Authorized official

Name
Dr. Roger Nakanishi, DDS, CDTNPI 1710082854
Title
Co Owner
Phone
(425) 883-2933

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 603-005-065 WA Primary

Addresses

Primary practice location

15955 NE 85TH St
Ste 101
Redmond, WA 98052-3550

Mailing address

15955 NE 85TH St
Ste 101
Redmond, WA 98052-3550
Phone (425) 883-2933

National Provider Directory

National Provider Directory

Locations

15955 NE 85th St
Ste 101
Redmond, WA 98052
Phone (425) 883-2933

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271376000000",
    "number": "1407172406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15955 NE 85TH ST",
            "address_2": "STE 101",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523550",
            "telephone_number": "425-883-2933",
            "fax_number": "425-885-0146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15955 NE 85TH ST",
            "address_2": "STE 101",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523550",
            "telephone_number": "425-883-2933",
            "fax_number": "425-885-0146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NW FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-15",
        "last_updated": "2010-04-16",
        "status": "A",
        "authorized_official_last_name": "NAKANISHI",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "425-883-2933",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, CDT"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "603-005-065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.