NPIMap

Individual provider Active NPI

Stephen Andrew Rodgers, DMD

  • Dentist
  • Woodinville, WA
National Provider Identifier
1649558446
Registry record updated Jun 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE 60149420 Issued in WA
Practice address
13515 NE 175TH, Ste. C
Woodinville, WA 98072
Phone
(425) 483-9000
Fax
(425) 481-6089
NPI assigned
Jul 27, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE 60149420 WA Primary

Addresses

Primary practice location

13515 NE 175TH, Ste. C
Woodinville, WA 98072

Mailing address

13515 NE 175TH, Ste. C
Woodinville, WA 98072
Phone (425) 483-9000

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

State licenses

LicenseStateTypeSpecialty
DE 60149420WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen a. Rodgers, DMD, PLLC Past Accepting new patients

Organizations & group practices 1

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": "1311724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340582400000",
    "number": "1649558446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13515 NE 175TH, STE. C",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "98072",
            "telephone_number": "425-483-9000",
            "fax_number": "425-481-6089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13515 NE 175TH, STE. C",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "98072",
            "telephone_number": "425-483-9000",
            "fax_number": "425-481-6089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGERS",
        "first_name": "STEPHEN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-27",
        "last_updated": "2012-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE 60149420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodinville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; 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.