Individual provider Active NPI

Janet Marie Miesel, DDS

  • Periodontics
  • Burlington, WA
National Provider Identifier
1497840714
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
8888 Issued in WA
Practice address
120 E George Hopper Rd Ste 215
Burlington, WA 98233-3125
Phone
(360) 757-7667
Fax
(360) 707-2114
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 8888 WA Primary

Addresses

Primary practice location

120 E George Hopper Rd Ste 215
Burlington, WA 98233-3125

Mailing address

120 E George Hopper Rd Ste 215
Burlington, WA 98233-3125
Phone (360) 757-7667

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
I20260604000750 WA Order and Referring Only - DentistPractitioner - Dentist 5294206850

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8888WAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Kathleen a Stambaugh, DDS PS PastSince Sep 23, 2021 Accepting new patients

Organizations & group practices 1

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1497840714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E GEORGE HOPPER RD STE 215",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982333125",
            "telephone_number": "360-757-7667",
            "fax_number": "360-707-2114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E GEORGE HOPPER RD STE 215",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982333125",
            "telephone_number": "360-757-7667",
            "fax_number": "360-707-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIESEL",
        "first_name": "JANET",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": "8888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, WA

Sources for this page

Verify at the official NPI Registry.