Active NPI
Jay L Enzler, D.D.S.
- Dentist
- Spokane, WA
National Provider Identifier
1710057021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8154
- Practice address
- 9302 N Colton St
Suite 100
Spokane, WA 99218 - Phone
- (509) 863-9460
- Fax
- (509) 868-0428
- NPI assigned
- Nov 8, 2006
- Last updated
- Mar 7, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8154 | WA | Primary |
| Pediatric Dentistry | 1223P0221X | 8154 | WA |
Addresses
Primary practice location
9302 N Colton St
Suite 100
Spokane, WA 99218
Mailing address
9302 N Colton St
Suite 100
Spokane, WA 99218
Phone (509) 863-9460
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8154 | Other | WA | STATE PROVIDER # |
| 5055645 | 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 |
|---|---|---|---|
| 8154 | WA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kirk Fuhriman PLLC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1710057021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9302 N COLTON ST",
"address_2": "SUITE 100",
"city": "SPOKANE",
"state": "WA",
"postal_code": "99218",
"telephone_number": "509-863-9460",
"fax_number": "509-868-0428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9302 N COLTON ST",
"address_2": "SUITE 100",
"city": "SPOKANE",
"state": "WA",
"postal_code": "99218",
"telephone_number": "509-863-9460",
"fax_number": "509-868-0428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENZLER",
"first_name": "JAY",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-08",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "8154",
"primary": true
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "WA",
"license": "8154",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE PROVIDER #",
"identifier": "8154",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5055645",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.