Individual provider Active NPI

Skyler Bryce Wolfgang Schubel, DMD

  • General Practice Dentistry
  • Seattle, WA
National Provider Identifier
1477059061
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
60947771 Issued in WA
Practice address
6111 15TH Ave NW
Seattle, WA 98107-2304
Phone
(206) 783-7700
NPI assigned
Apr 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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 60947771 WA Primary

Addresses

Primary practice location

6111 15TH Ave NW
Seattle, WA 98107-2304

Mailing address

6111 15TH Ave NW
Seattle, WA 98107-2304
Phone (206) 783-7700

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
I20190725002264 WA Order and Referring Only - DentistPractitioner - Dentist 2668708868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60947771WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Skyler BW Schubel DMD PLLC CurrentSince Sep 20, 2022 Accepting new patients
Washington Dental Corporation, PC General Practice Past Accepting new patients
Hidden Valley Smiles Dentist PastSince Aug 1, 2021 Accepting new patients
Wedgwood Smiles PastSince Oct 1, 2021 Accepting new patients

Locations

6111 15th Ave NW
Seattle, WA 98107
Phone (206) 783-7700

Organizations & group practices 4

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": "1522627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1477059061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6111 15TH AVE NW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981072304",
            "telephone_number": "206-783-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6111 15TH AVE NW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981072304",
            "telephone_number": "206-783-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUBEL",
        "first_name": "SKYLER",
        "middle_name": "BRYCE WOLFGANG",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-02",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "60947771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.