NPIMap

Individual provider Active NPI

Victor Bauer, DDS

  • Dentist
  • Bellevue, WA
National Provider Identifier
1487271425
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
61085039 Issued in WA
Practice address
4100 Factoria Blvd SE Ste a
Bellevue, WA 98006-1262
Phone
(425) 643-5778
NPI assigned
Jun 25, 2020
Last updated
Jan 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X TP61085485 WA
Dentist 122300000X 61085039 WA Primary

Addresses

Primary practice location

4100 Factoria Blvd SE Ste a
Bellevue, WA 98006-1262

Mailing address

4100 Factoria Blvd SE Ste a
Bellevue, WA 98006-1262

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL slack.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
61085039WAMDDentist
TP61085485WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Victor H Bauer DDS PLLC CurrentSince Feb 8, 2023 Accepting new patients
Austin & Galloway PastSince Feb 8, 2023 Accepting new patients
Broughton Dunn PLLC Past Accepting new patients
Broughton Dunn PLLC Past Accepting new patients
Broughton Dunn PLLC Past Accepting new patients

Locations

4100 Factoria Blvd SE
Ste A
Bellevue, WA 98006
Phone (206) 295-5721

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1487271425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 FACTORIA BLVD SE STE A",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 FACTORIA BLVD SE STE A",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061262",
            "telephone_number": "425-643-5778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-25",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "TP61085485",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "61085039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "slack.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8012 112th Street Ct E Ste 320",
            "city": "Puyallup",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983737856",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.