Individual provider Active NPI

Jonathan David Everett, D.D.S.

  • General Practice Dentistry
  • Burien, WA
National Provider Identifier
1619352952
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE 60570044 Issued in WA
Practice address
115 S 177TH PL
Burien, WA 98148-1715
Phone
(206) 242-1500
Fax
(206) 246-1565
NPI assigned
Jul 28, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE 60570044 WA Primary

Addresses

Primary practice location

115 S 177TH PL
Burien, WA 98148-1715

Mailing address

115 S 177TH PL
Burien, WA 98148-1715
Phone (206) 242-1500

Other practice location 1

13531 Juanita Woodinville Way NE
Kirkland, WA 98034-5225
Phone (425) 822-0435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160816003078 WA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6800181710

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE 60570044WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan Everett DDS PLLC Current Accepting new patients
Greene, Everett and Choi PLLC Past Accepting new patients
Daniel Travelle DDS and Kathleen Travelle DDS, PLLC Past Accepting new patients

Locations

115 S 177th Pl
Seattle, WA 98148
Phone (206) 242-1500

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1619352952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S 177TH PL",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981481715",
            "telephone_number": "206-242-1500",
            "fax_number": "206-246-1565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S 177TH PL",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981481715",
            "telephone_number": "206-242-1500",
            "fax_number": "206-246-1565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13531 Juanita Woodinville Way NE",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980345225",
            "country_code": "US",
            "telephone_number": "425-822-0435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVERETT",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-28",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE 60570044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

Verify at the official NPI Registry.