Active NPI
Greggory A Kinzer, DDS MSD
- Prosthodontics
- Seattle, WA
National Provider Identifier
1700966991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- DE00008164
- Practice address
- 600 Broadway Ste 490
Seattle, WA 98122-5312 - Phone
- (206) 223-0033
- Fax
- (206) 860-2868
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | DE00008164 | WA | Primary |
Addresses
Primary practice location
600 Broadway Ste 490
Seattle, WA 98122-5312
Mailing address
600 Broadway Ste 490
Seattle, WA 98122-5312
Phone (206) 223-0033
Medicare participation
Medicare enrollment files- 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
- Opted out of Medicare
- Yes, effective Oct 21, 2015 through Oct 21, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE00008164 | WA | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366675200000",
"number": "1700966991",
"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"
},
{
"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",
"fax_number": "206-860-2868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINZER",
"first_name": "GREGGORY",
"middle_name": "A",
"credential": "DDS MSD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2013-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "WA",
"license": "DE00008164",
"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 23, 2013; 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.