Active NPI
Joshua Archer Manchester, D.D.S.
- Dentist
- Kenmore, WA
National Provider Identifier
1669817953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE60579609
- Practice address
- 5630 NE 198TH PL
Kenmore, WA 98028-3113 - Phone
- (406) 599-4642
- NPI assigned
- May 1, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE60579609 | WA | Primary |
Addresses
Primary practice location
5630 NE 198TH PL
Kenmore, WA 98028-3113
Mailing address
11056 SE 201St Place
Kent, WA 98031
Phone (406) 599-4642
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
| License | State | Type | Specialty |
|---|---|---|---|
| DE60579609 | WA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J a Manchester DDS 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.
-
- Prosthodontics
- Tacoma, WA
- NPI 1528857208
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506038400000",
"number": "1669817953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11056 SE 201ST PLACE",
"city": "KENT",
"state": "WA",
"postal_code": "98031",
"telephone_number": "406-599-4642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5630 NE 198TH PL",
"city": "KENMORE",
"state": "WA",
"postal_code": "980283113",
"telephone_number": "406-599-4642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANCHESTER",
"first_name": "JOSHUA",
"middle_name": "ARCHER",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-01",
"last_updated": "2017-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE60579609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenmore, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.