Individual provider Active NPI

Richard Stickney, DDS

  • General Practice Dentistry
  • Seattle, WA
National Provider Identifier
1700103330
Registry record updated Apr 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4260 Issued in WA
Practice address
2107 Elliott Ave
Suite 210
Seattle, WA 98121-2186
Phone
(206) 728-1330
Fax
(206) 728-1505
NPI assigned
Apr 21, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4260 WA Primary

Addresses

Primary practice location

2107 Elliott Ave
Suite 210
Seattle, WA 98121-2186

Mailing address

2107 Elliott Ave
Suite 210
Seattle, WA 98121-2186
Phone (206) 728-1330

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
4260WAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271808000000",
    "number": "1700103330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2107 ELLIOTT AVE",
            "address_2": "SUITE 210",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981212186",
            "telephone_number": "206-728-1330",
            "fax_number": "206-728-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 ELLIOTT AVE",
            "address_2": "SUITE 210",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981212186",
            "telephone_number": "206-728-1330",
            "fax_number": "206-728-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STICKNEY",
        "first_name": "RICHARD",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-21",
        "last_updated": "2010-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "4260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2010; 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.