Donald A Koontz, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

6865 Issued in WA

Practice address

12806 3Rd Ave SE
Everett, WA 98208-6455

Phone

(425) 338-0666

Fax

(425) 337-6570

NPI assigned

Oct 5, 2006

Sex

Male

Sole proprietor

Yes

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

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.

• North Creek Dental Care

  • General Practice Dentistry
  • Everett, WA
  • NPI 1669926515
  NPD (past) Authorized official

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548356918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16518 39TH AVE NE",
            "city": "LAKE FOREST PARK",
            "state": "WA",
            "postal_code": "981555602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12806 3RD AVE SE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982086455",
            "telephone_number": "425-338-0666",
            "fax_number": "425-337-6570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONTZ",
        "first_name": "DONALD",
        "middle_name": "A",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "6865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ST. DENTAL LICENSE #",
            "identifier": "6865",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Komissarchik
• Ajitha Kommalapati, MD
• Tracy Kondracki
• Mariama L Konteh
• Kenny P Koo, M.D.
• Colleen Koorn, ARNP
• Julia M Kopcak, PA-C
• Janae Kopet
• Felmas Adhiambo Koranga
• Jaye Michelle Koropp, BA,, PEER COUNSELOR

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.