Active NPI
Mary Elizabeth Bisese, DDS
- Dentist
- Bellingham, WA
National Provider Identifier
1700945870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7136
- Practice address
- 1301 J St
Bellingham, WA 98229-3251 - Phone
- (360) 676-7130
- Fax
- (360) 676-1125
- NPI assigned
- Dec 6, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 7136 | WA | Primary |
Addresses
Primary practice location
1301 J St
Bellingham, WA 98229-3251
Mailing address
1301 J St
Bellingham, WA 98229-3251
Phone (360) 676-7130
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5018684 | Medicaid | WA |
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 |
|---|---|---|---|
| 7136 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700945870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 J ST",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982293251",
"telephone_number": "360-676-7130",
"fax_number": "360-676-1125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 J ST",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982293251",
"telephone_number": "360-676-7130",
"fax_number": "360-676-1125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BISESE",
"first_name": "MARY ELIZABETH",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "7136",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5018684",
"state": "WA"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.