Individual provider Active NPI

Leena L King, DMD

  • Pediatric Dentistry
  • Marysville, WA
National Provider Identifier
1447457155
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DE000107939 Issued in WA
Practice address
9710 State Ave
Marysville, WA 98270-2280
Phone
(360) 657-3091
Fax
(360) 657-5732
NPI assigned
Jun 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DE000107939 WA Primary

Addresses

Primary practice location

9710 State Ave
Marysville, WA 98270-2280

Mailing address

PO Box 34703
Seattle, WA 98124-1703
Phone (206) 764-3335

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160803002484 WA Order and Referring Only - Other (Non-Physician) 6901190651

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE000107939WAMDPediatric Dentist

Interoperability endpoints

  • Direct secure messaging: lking452754@direct.multicare.org

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212624000000",
    "number": "1447457155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703",
            "telephone_number": "206-764-3335",
            "fax_number": "206-764-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9710 STATE AVE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982702280",
            "telephone_number": "360-657-3091",
            "fax_number": "360-657-5732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "LEENA",
        "middle_name": "L",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2008-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE000107939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, WA

Sources for this page

Verify at the official NPI Registry.