Individual provider Active NPI

Mikael B Kautsky, DDS, PHD

  • General Practice Dentistry
  • Olympia, WA
National Provider Identifier
1427057066
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE 7768 Issued in WA
Practice address
1100 Eastside St SE
#4
Olympia, WA 98501-7304
Phone
(360) 943-6378
Fax
(360) 705-3159
NPI assigned
Jul 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE 7768 WA Primary

Addresses

Primary practice location

1100 Eastside St SE
#4
Olympia, WA 98501-7304

Mailing address

908 Delta LN SE
Tumwater, WA 98501-4672

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
DE 7768WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mikael Kautsky D D S P S PastSince Jul 1, 2001 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": "1121472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1427057066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 DELTA LN SE",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985014672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 EASTSIDE ST SE",
            "address_2": "#4",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985017304",
            "telephone_number": "360-943-6378",
            "fax_number": "360-705-3159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUTSKY",
        "first_name": "MIKAEL",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DDS, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE 7768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.