Active NPI
Patrick J. Pacyga, D.D.S.
- General Practice Dentistry
- Bellingham, WA
National Provider Identifier
1699213439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DE 60713326
- Practice address
- 1616 Cornwall Ave Ste 205
Bellingham, WA 98225-4642 - Phone
- (360) 676-6177
- Fax
- (360) 671-3574
- NPI assigned
- Feb 1, 2017
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DE 60713326 | WA | Primary |
Addresses
Primary practice location
1616 Cornwall Ave Ste 205
Bellingham, WA 98225-4642
Mailing address
9515 Interlake Ave N
Apt. 101
Seattle, WA 98103-3380
Phone (206) 402-9289
Other practice location 1
19620 Wa-99
Suite 106
Lynnwood, WA 98036
Phone (425) 670-1144
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180604000699 | WA | Order and Referring Only - Dentist | 1153686696 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE 60713326 | WA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681948800000",
"number": "1699213439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9515 INTERLAKE AVE N",
"address_2": "APT. 101",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981033380",
"telephone_number": "206-402-9289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1616 CORNWALL AVE STE 205",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982254642",
"telephone_number": "360-676-6177",
"fax_number": "360-671-3574"
}
],
"practiceLocations": [
{
"address_1": "19620 WA-99",
"address_2": "Suite 106",
"address_purpose": "LOCATION",
"city": "Lynnwood",
"state": "WA",
"postal_code": "98036",
"country_code": "US",
"telephone_number": "425-670-1144",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PACYGA",
"first_name": "PATRICK",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-02-01",
"last_updated": "2023-04-20",
"certification_date": "2023-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "DE 60713326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bellingham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.