Nikolas Edward Rawley, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60262496 Issued in WA

Practice address

12711 SE Mill Plain Blvd
Vancouver, WA 98684-6053

Phone

(360) 896-4484

NPI assigned

Nov 11, 2009

Last updated

Apr 25, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kaiser Permanente Dental Care Program

  • Dental Hygienist
  • Vancouver, WA
  • NPI 1043224678
  NPD (past)

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

{
    "created_epoch": "1257897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335312000000",
    "number": "1487981478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12711 SE MILL PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986846053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12711 SE MILL PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986846053",
            "telephone_number": "360-896-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAWLEY",
        "first_name": "NIKOLAS",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-11",
        "last_updated": "2012-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9369",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60262496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Vancouver, WA
• Providers in Vancouver, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.