NPIMap

Organization Active NPI

Nicholas Koogler DDS PLLC

  • General Practice Dentistry
  • Bellevue, WA
National Provider Identifier
1578285086
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NICHOLAS KOOGLER DDS PLLC
Practice address
40 Lake Bellevue Dr Ste 250
Bellevue, WA 98005-2478
Phone
(425) 209-0700
NPI assigned
Sep 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Authorized official

Name
Nicholas James Koogler, DDSNPI 1396180022
Title
Owner
Phone
(614) 371-1830

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

40 Lake Bellevue Dr Ste 250
Bellevue, WA 98005-2478

Mailing address

7219 221St Ave NE
Redmond, WA 98053-5927
Phone (614) 371-1830

Other practice location 1

500 E Howell St
Seattle, WA 98122-2140
Phone (425) 324-9877

Other names 2

  • Cascade Integrative Dentistry Doing business as
  • Washington Center for Sleep Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221201001777 WA DME Supplier - Oral Surgery - Dentist 9335517960 Practice locations: Bellevue, WA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Cascade Integrative Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

500 E Howell St
Seattle, WA 98122
Phone (206) 324-9877

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1663027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698969600000",
    "number": "1578285086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7219 221ST AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980535927",
            "telephone_number": "614-371-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 LAKE BELLEVUE DR STE 250",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052478",
            "telephone_number": "425-209-0700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 E Howell St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981222140",
            "country_code": "US",
            "telephone_number": "425-324-9877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NICHOLAS KOOGLER DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-13",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A",
        "authorized_official_last_name": "KOOGLER",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-371-1830",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cascade Integrative Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Washington Center for Sleep",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.