Active NPI
Darrell Rick Edwards, D.D.S.
- Oral and Maxillofacial Pathology Dentistry
- Federal Way, WA
National Provider Identifier
1598974339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Pathology Dentistry
- License
- 6652
- Practice address
- 2345 SW 320TH St
Federal Way, WA 98023-2568 - Phone
- (253) 838-2123
- Fax
- (253) 874-3624
- NPI assigned
- May 21, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Pathology Dentistry | 1223P0106X | 6652 | WA | Primary |
Addresses
Primary practice location
2345 SW 320TH St
Federal Way, WA 98023-2568
Mailing address
2345 SW 320TH St
Federal Way, WA 98023-2568
Phone (253) 838-2123
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 4, 2023 through Jan 4, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6652 | WA | MD | Oral and Maxillofacial Pathology Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Edwards, Johnson, Johnson & Johnson D.D.S., P.L.L.C. | Past | 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.
-
dba Pacific Northwest Oral & Maxillofacial Surgeons
- Oral and Maxillofacial Surgery (Dentist)
- Renton, WA
- NPI 1255803904
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475798400000",
"number": "1598974339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2345 SW 320TH ST",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980232568",
"telephone_number": "253-838-2123",
"fax_number": "253-874-3624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2345 SW 320TH ST",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980232568",
"telephone_number": "253-838-2123",
"fax_number": "253-874-3624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "DARRELL",
"middle_name": "RICK",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-21",
"last_updated": "2016-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0106X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Pathology",
"state": "WA",
"license": "6652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Federal Way, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.