Individual provider Active NPI

Sara Shateri, DDS

  • Student in an Organized Health Care Education/Training Program
  • Othello, WA
National Provider Identifier
1629866090
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1515 E Columbia St
Othello, WA 99344-1846
Phone
(525) 650-9488
NPI assigned
Apr 28, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1515 E Columbia St
Othello, WA 99344-1846

Mailing address

8180 Dune Lake Rd SE
Moses Lake, WA 98837-8258
Phone (509) 237-9428

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1745798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1629866090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8180 DUNE LAKE RD SE",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988378258",
            "telephone_number": "509-237-9428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E COLUMBIA ST",
            "city": "OTHELLO",
            "state": "WA",
            "postal_code": "993441846",
            "telephone_number": "525-650-9488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHATERI",
        "first_name": "SARA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Othello, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.