NPIMap

Individual provider Active NPI

Ariel J Raigrodski, DMD, MS, FACP, PLLC

  • Prosthodontics
  • Lynnwood, WA
National Provider Identifier
1639347552
Registry record updated Jan 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
000009970 Issued in WA
Practice address
19020 33Rd Ave W
Suite 200
Lynnwood, WA 98036-4746
Phone
(425) 711-2022
NPI assigned
Feb 13, 2008
Last updated
Jan 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 000009970 WA Primary

Addresses

Primary practice location

19020 33Rd Ave W
Suite 200
Lynnwood, WA 98036-4746

Mailing address

19020 33Rd Ave W
Suite 200
Lynnwood, WA 98036-4746
Phone (425) 771-2022

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
000009970WAMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Norman P Goodwin DDS PS Past Accepting new patients
Ariel J. Raigrodski, DMD, PLLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1639347552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W",
            "address_2": "SUITE 200",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364746",
            "telephone_number": "425-771-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W",
            "address_2": "SUITE 200",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364746",
            "telephone_number": "425-711-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAIGRODSKI",
        "first_name": "ARIEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD, MS, FACP, PLLC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-13",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "WA",
            "license": "000009970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2016; 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.