Angel Luis Aviles, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DE00009775 Issued in WA

Practice address

14655 Bel Red Rd
Suite 201
Bellevue, WA 98007-3900

Phone

(425) 614-3636

Fax

(425) 614-1074

NPI assigned

Feb 28, 2007

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467589952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14655 BEL RED RD",
            "address_2": "SUITE 201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073900",
            "telephone_number": "425-614-3636",
            "fax_number": "425-614-1074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14655 BEL RED RD",
            "address_2": "SUITE 201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073900",
            "telephone_number": "425-614-3636",
            "fax_number": "425-614-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILES",
        "first_name": "ANGEL",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "DE00009775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Bellevue, WA
• Endodontics in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.