Jill Ellen Kinzer, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

WA8740 Issued in WA

Practice address

600 Broadway Ste 490
Seattle, WA 98122-5312

Phone

(206) 223-0033

NPI assigned

Sep 13, 2005

Last updated

Jul 17, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jill Ellen Nyboer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Aug 30, 2015 through Aug 30, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Jill E. Hansen DDS, PS

  • General Practice Dentistry
  • Gig Harbor, WA
  • NPI 1184840548
  NPD (past)
• Melissa J. Spaulding, PLLC

  dba Spaulding Dental Company

  • General Practice Dentistry
  • Gig Harbor, WA
  • NPI 1033768452
  NPD (past)

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1679568026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 BROADWAY STE 490",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225312",
            "telephone_number": "206-223-0033",
            "fax_number": "253-853-6681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 BROADWAY STE 490",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225312",
            "telephone_number": "206-223-0033"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6659 Kimball Dr. NW Suite D- 401",
            "address_purpose": "LOCATION",
            "city": "Gig Harbor",
            "state": "WA",
            "postal_code": "98335",
            "country_code": "US",
            "telephone_number": "253-858-9169",
            "fax_number": "253-853-6681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINZER",
        "first_name": "JILL",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-13",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "WA8740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "NYBOER",
            "middle_name": "ELLEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sureen Kinuthia
• Josphine Kinyanjui, LPN
• James L Kinyoun
• Melissa Jean Kinyoun, CDPT
• Greggory A Kinzer, DDS MSD
• Cecilia Kioa
• Heather L. Kipa-Joseph, DO
• Jasmine Kipke, MD
• Sheryl Kipnis, ND
• Lauren A. Kipp, SLP

• General Practice Dentistry in Seattle, WA
• Providers in Seattle, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.