Individual provider Active NPI

Robert Denslow, DMD

  • Dentist
  • Tacoma, WA
National Provider Identifier
1407544794
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE61442937 Issued in WA
Practice address
3866 S 74TH St Ste 200
Tacoma, WA 98409-9908
Phone
(855) 433-6825
NPI assigned
Apr 26, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X DE61442937 WA Primary

Addresses

Primary practice location

3866 S 74TH St Ste 200
Tacoma, WA 98409-9908

Mailing address

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

Other practice location 1

3532 262nd Ave SE
Sammamish, WA 98075-9109
Phone (425) 785-7756

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
I20240131002789 WA Order and Referring Only - DentistPractitioner - Dentist 9537512082

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE61442937WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Willamette Dental Group, P.C. Dentist PastSince Jan 21, 2024 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.

NPI Registry JSON

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1407544794",
    "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": "3866 S 74TH ST STE 200",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984099908",
            "telephone_number": "855-433-6825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3532 262nd Ave SE",
            "address_purpose": "LOCATION",
            "city": "Sammamish",
            "state": "WA",
            "postal_code": "980759109",
            "country_code": "US",
            "telephone_number": "425-785-7756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENSLOW",
        "first_name": "ROBERT",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-26",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61442937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.