NPIMap

Organization Active NPI

Nicholas Raklios, DDS, PLLC

Doing business as Pristera Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Renton, WA
National Provider Identifier
1487222725
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
NICHOLAS RAKLIOS, DDS, PLLC
Doing business as
Pristera Orthodontics
Practice address
350 S 38TH CT Ste 215
Renton, WA 98055-5777
Phone
(208) 918-8075
NPI assigned
Jun 14, 2021
Last updated
May 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Authorized official

Name
Cassandra Wieth
Title
Payor Relations Manager
Phone
(623) 267-8121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

350 S 38TH CT Ste 215
Renton, WA 98055-5777

Mailing address

350 S 38TH CT Ste 215
Renton, WA 98055-5777
Phone (208) 918-8075

Other practice location 1

116 SW 160th St
Burien, WA 98166-3025
Phone (208) 918-8075

Other names 1

  • Pristera Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Nicholas Raklios DDS PLLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

26812 Maple Valley Black Diamond Rd SE
Maple Valley, WA 98038
Phone (208) 918-8075

350 S 38th Ct
Ste 215
Renton, WA 98055
Phone (208) 918-8075

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715212800000",
    "number": "1487222725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 S 38TH CT STE 215",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555777",
            "telephone_number": "208-918-8075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S 38TH CT STE 215",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555777",
            "telephone_number": "208-918-8075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "116 SW 160th St",
            "address_purpose": "LOCATION",
            "city": "Burien",
            "state": "WA",
            "postal_code": "981663025",
            "country_code": "US",
            "telephone_number": "208-918-8075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NICHOLAS RAKLIOS, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-14",
        "last_updated": "2024-05-09",
        "certification_date": "2024-03-28",
        "status": "A",
        "authorized_official_last_name": "WIETH",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "PAYOR RELATIONS MANAGER",
        "authorized_official_telephone_number": "623-267-8121"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pristera Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.