Jennifer Marie Dolan, DDS, MPH, MHSA
Individual provider Active NPI Dentist · Graham, WA
NPI 1609379031 · NPPES record last updated Mar 18, 2026
Key facts
- NPI
- 1609379031
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 61519974 (WA)
- Practice address
- 21110 Meridian E Ste E3
Graham, WA 98338-5706 - Phone
- (253) 559-1660
- NPI assigned
- Mar 12, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181228001979 | FL | Order and Referring Only - Oral Surgery |
0941545560 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23306 | FL | MD | Dentist |
| D12295 | OR | MD | Dentist |
| 61519974 | WA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nurani, Mitchell, Kim, PC | Dentist | Past | Accepting new patients |
| Abedi PLLC | Past |
Accepting new patients | |
| Consumerhealth, Inc. | Past | Accepting new patients | |
| Nurani, Mitchell, Kim, PC | Dentist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D12295 | OR | |
| Dentist | 122300000X | 23306 | FL | |
| Dentist | 122300000X | 61519974 | WA | Yes |
Addresses
Primary practice location
21110 Meridian E Ste E3
Graham, WA 98338-5706
Mailing address
21110 Meridian E Ste E3
Graham, WA 98338-5706
Phone (586) 362-0058
Other practice location 1
10321 Gravelly Lake Dr SW
Lakewood, WA 98499-5017
Phone (253) 292-4041
Other practice location 2
4104 SE 82nd Ave Ste 450
Portland, OR 97266-2958
Phone (503) 777-0761 ext. 70761
Other practice location 3
10404 Silverdale Way NW Ste E109
Silverdale, WA 98383-1015
Phone (360) 536-9033
Other providers in Graham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.