Jorge Abel Vizcarra, LD

Primary specialty

DenturistTaxonomy code 122400000X

License

DN00000259 Issued in WA

Practice address

12733 Lake City Way NE Ste 301
Seattle, WA 98125-4490

Phone

(206) 365-5060

Fax

(206) 417-3047

NPI assigned

Sep 11, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Denture Clinic, Inc.

  • Denturist
  • Seattle, WA
  • NPI 1922258037
  NPD (past) Authorized official

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441929600000",
    "number": "1629446364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12733 LAKE CITY WAY NE STE 301",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981254490",
            "telephone_number": "206-365-5060",
            "fax_number": "206-417-3047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12733 LAKE CITY WAY NE STE 301",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981254490",
            "telephone_number": "206-365-5060",
            "fax_number": "206-417-3047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIZCARRA",
        "first_name": "JORGE",
        "middle_name": "ABEL",
        "credential": "LD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-11",
        "last_updated": "2015-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "",
            "desc": "Denturist",
            "state": "WA",
            "license": "DN00000259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSHS PROVIDER",
            "identifier": "DSHS 5057865",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jocelyn Sabrina Vivas Castillo
• Meghana Vivek, MD
• Nicole Zeoli Vivelo, ACNP
• Ariana Viveros, RC
• Paige Katherine Vivian, DPT
• Karrah Vizcarra
• Grace Marie Vizzare
• Vladimer Stepania
• Luka Vlahovic, MD
• Brien W. Vlcek, MD

• Denturist in Seattle, WA
• Providers in Seattle, WA by specialty
• Denturist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; 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.