Michael Nelson, D.D.S.
Individual provider Active NPI General Practice Dentistry · Lake Tapps, WA
NPI 1699018192 · NPPES record last updated Apr 3, 2013
Key facts
- NPI
- 1699018192
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 5299 (WA)
- Practice address
- 2803 176TH Ave East
Lake Tapps, WA 98391 - Phone
- (425) 271-7740
- NPI assigned
- Apr 3, 2013
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5299 | WA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5299 | WA | Yes |
Addresses
Primary practice location
2803 176TH Ave East
Lake Tapps, WA 98391
Mailing address
2803 176TH Ave East
Lake Tapps, WA 98391
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- Valerie M Neuman
- Janae Neumeier
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All providers in Lake Tapps, WA · General Practice Dentistry in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.