Timur Ernafasov, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE00010048 Issued in WA

Practice address

610 W Meeker St
Suite #102
Kent, WA 98032-5726

Phone

(253) 852-6080

Fax

(253) 852-6099

NPI assigned

Jul 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Timur Ernafasov Inc

  • General Practice Dentistry
  • Kent, WA
  • NPI 1427917137
  NPD

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1487685376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12549 ROOSEVELT WAY NE APT 7",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981253973",
            "telephone_number": "253-852-6080",
            "fax_number": "253-852-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 W MEEKER ST",
            "address_2": "SUITE #102",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980325726",
            "telephone_number": "253-852-6080",
            "fax_number": "253-852-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERNAFASOV",
        "first_name": "TIMUR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00010048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5047519",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Kent, WA
• Providers in Kent, WA by specialty
• Dentist in Washington

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