Individual provider Active NPI

Sneha Yerra

  • Dentist
  • Edmonds, WA
National Provider Identifier
1659800993
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
60945488 Issued in WA
Practice address
9529 244TH St SW
Edmonds, WA 98020-6527
Phone
(206) 542-7557
NPI assigned
Jun 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10697 NC
Dentist 122300000X 60945488 WA Primary

Addresses

Primary practice location

9529 244TH St SW
Edmonds, WA 98020-6527

Mailing address

120 Westlake Ave N Apt 301
Seattle, WA 98109-5243

Other practice location 1

523 Nc Highway 125
Roanoke Rapids, NC 27870-6447
Phone (252) 533-9300

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
60945488WAMDDentist
10697NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sneha Yerra DMD PLLC Dentist Current Accepting new patients
James D. Haberman, Jr. DDS, PLLC CurrentSince Jan 19, 2020 Accepting new patients
Brian L Maynor D.D.S., PLLC Past Accepting new patients

Locations

9529 244th St SW
Edmonds, WA 98020
Phone (206) 542-7557

Organizations & group practices 3

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": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1659800993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WESTLAKE AVE N APT 301",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981095243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9529 244TH ST SW",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980206527",
            "telephone_number": "206-542-7557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "523 Nc Highway 125",
            "address_purpose": "LOCATION",
            "city": "Roanoke Rapids",
            "state": "NC",
            "postal_code": "278706447",
            "country_code": "US",
            "telephone_number": "252-533-9300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YERRA",
        "first_name": "SNEHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-09",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "10697",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "60945488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.