Individual provider Active NPI

Jonathan Todorovich, D.D.S.

  • Dentist
  • Bellingham, WA
National Provider Identifier
1477006765
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60672126 Issued in WA
Practice address
1616 Cornwall Ave Ste 205
Bellingham, WA 98225
Phone
(360) 676-6177
NPI assigned
Aug 3, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE60672126 WA
Dentist 122300000X DE60672126 WA Primary

Addresses

Primary practice location

1616 Cornwall Ave Ste 205
Bellingham, WA 98225

Mailing address

1616 Cornwall Ave
Bellingham, WA 98225-4648
Phone (360) 676-6177

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
I20160926001796 WA Order and Referring Only - DentistPractitioner - Dentist 5597052100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE60672126WAMDDentist

Interoperability endpoints

  • Direct secure messaging: jtodorovich338050@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1477006765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 CORNWALL AVE",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254648",
            "telephone_number": "360-676-6177",
            "fax_number": "360-671-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 CORNWALL AVE STE 205",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "98225",
            "telephone_number": "360-676-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODOROVICH",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-03",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60672126",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60672126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.