Individual provider Active NPI

Max Jin Zhe Cai, DDS

  • Dentist
  • Grandview, WA
National Provider Identifier
1407555931
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE61368462 Issued in WA
Practice address
1000 Wallace Way
Grandview, WA 98930-8805
Phone
(509) 882-3444
Fax
(509) 882-1097
NPI assigned
Feb 23, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE61368462 WA Primary

Addresses

Primary practice location

1000 Wallace Way
Grandview, WA 98930-8805

Mailing address

1000 Wallace Way
Grandview, WA 98930-8805
Phone (509) 882-3444

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
I20230719002687 WA Order and Referring Only - DentistPractitioner - Dentist 5890155063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE61368462WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1677110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1407555931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 WALLACE WAY",
            "city": "GRANDVIEW",
            "state": "WA",
            "postal_code": "989308805",
            "telephone_number": "509-882-3444",
            "fax_number": "509-882-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WALLACE WAY",
            "city": "GRANDVIEW",
            "state": "WA",
            "postal_code": "989308805",
            "telephone_number": "509-882-3444",
            "fax_number": "509-882-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAI",
        "first_name": "MAX JIN ZHE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-23",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61368462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandview, WA

Sources for this page

Verify at the official NPI Registry.