Individual provider Active NPI

Nisha Sharoff Ashwin, DDS,MS

  • Oral and Maxillofacial Surgery (Dentist)
  • Seattle, WA
National Provider Identifier
1720579378
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DE60800403 Issued in WA
Practice address
9650 15TH Ave SW Ste 100
Seattle, WA 98106
Phone
(206) 965-1005
Fax
(206) 965-1042
NPI assigned
May 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE60800403 WA
General Practice Dentistry 1223G0001X DE60800403 WA
Orofacial Pain Dentistry 1223X2210X 60800403 WA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DE60800403 WA Primary

Addresses

Primary practice location

9650 15TH Ave SW Ste 100
Seattle, WA 98106

Mailing address

PO Box 34703
Seattle, WA 98124-1703

Other practice location 1

1515 E Columbia St
Othello, WA 99344-1846
Phone (509) 488-5256 ext. 8512

Other identifiers 1

IdentifierTypeStateIssuer
2100188MedicaidWA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210721004075 WA Practitioner - Oral SurgeryPractitioner - Dentist 8123427796 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DE60800403WAMDGeneral Practice Dentistry
60800403WAMDOrofacial Pain Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Basin Health Association CurrentSince Aug 1, 2021 Accepting new patients
Sea Mar Community Health Centers CurrentSince Aug 16, 2021 Accepting new patients
Columbia Basin Health Association CurrentSince Aug 1, 2021 Accepting new patients
Columbia Basin Health Association Current Accepting new patients
Sea Mar Community Health Centers Current Accepting new patients
Sea Mar Community Health Centers CurrentSince Aug 16, 2021 Accepting new patients

Locations

601 Government Rd
Mattawa, WA 99349
Phone 5094885256 ext. 8512

1515 E Columbia St
Othello, WA 99344
Phone (509) 488-5250

9650 15th Ave SW
Ste 100
Seattle, WA 98106
Phone (206) 965-1000

9650 15th Ave SW
Seattle, WA 98106
Phone (206) 965-1000

8720 14th Ave S
Seattle, WA 98108
Phone (206) 762-3730

Interoperability endpoints

  • Direct secure messaging: nsharoffashwin586773@direct.multicare.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1526601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1720579378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9650 15TH AVE SW STE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98106",
            "telephone_number": "206-965-1005",
            "fax_number": "206-965-1042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 E Columbia St",
            "address_purpose": "LOCATION",
            "city": "Othello",
            "state": "WA",
            "postal_code": "993441846",
            "country_code": "US",
            "telephone_number": "509-488-5256 x8512",
            "fax_number": "509-488-9939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAROFF ASHWIN",
        "first_name": "NISHA",
        "name_prefix": "Dr.",
        "credential": "DDS,MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-18",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60800403",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60800403",
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "WA",
            "license": "60800403",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE60800403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2100188",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.