Individual provider Active NPI

Kim Sue Okamura, DDS

  • Dentist
  • Seattle, WA
National Provider Identifier
1568562734
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6248 Issued in WA
Practice address
11730 15TH Ave NE
Seattle, WA 98125
Phone
(206) 362-3200
Fax
(206) 362-0621
NPI assigned
Sep 25, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6248 WA Primary

Addresses

Primary practice location

11730 15TH Ave NE
Seattle, WA 98125

Mailing address

11730 15TH Ave NE
Seattle, WA 98125
Phone (206) 362-3200

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6248WAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568562734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11730 15TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98125",
            "telephone_number": "206-362-3200",
            "fax_number": "206-362-0621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11730 15TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98125",
            "telephone_number": "206-362-3200",
            "fax_number": "206-362-0621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKAMURA",
        "first_name": "KIM",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "6248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • 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.