NPIMap

Organization Active NPI

Lourdes M Acuesta DDS PS

  • General Practice Dentistry
  • Seattle, WA
National Provider Identifier
1659480622
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00005777 Issued in WA
Legal business name
LOURDES M ACUESTA DDS PS
Practice address
1500 Fairview Ave E
Suite 302
Seattle, WA 98102-3727
Phone
(206) 322-7706
Fax
(206) 329-5214
NPI assigned
Aug 30, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Lourdes Mancol Acuesta, DDSNPI 1891804829
Title
Owner
Phone
(206) 322-7706

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE00005777 WA Primary

Addresses

Primary practice location

1500 Fairview Ave E
Suite 302
Seattle, WA 98102-3727

Mailing address

1500 Fairview Ave E
Suite 302
Seattle, WA 98102-3727
Phone (206) 322-7706

Other identifiers 1

IdentifierTypeStateIssuer
5000393MedicaidWA

National Provider Directory

National Provider Directory

Locations

1500 Fairview Ave E
Ste 302
Seattle, WA 98102
Phone (206) 322-7706

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659480622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 FAIRVIEW AVE E",
            "address_2": "SUITE 302",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981023727",
            "telephone_number": "206-322-7706",
            "fax_number": "206-329-5214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 FAIRVIEW AVE E",
            "address_2": "SUITE 302",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981023727",
            "telephone_number": "206-322-7706",
            "fax_number": "206-329-5214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOURDES M ACUESTA DDS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ACUESTA",
        "authorized_official_first_name": "LOURDES",
        "authorized_official_middle_name": "MANCOL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-322-7706",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00005777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5000393",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.