Individual provider Active NPI

Craig Eugene Pearce, D.M.D.

  • Prosthodontics
  • Everett, WA
National Provider Identifier
1730182536
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DE00007785 Issued in WA
Practice address
5920 Evergreen Way
Ste E
Everett, WA 98203-6005
Phone
(425) 353-4884
Fax
(425) 353-6197
NPI assigned
May 24, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X DE00007785 WA Primary

Addresses

Primary practice location

5920 Evergreen Way
Ste E
Everett, WA 98203-6005

Mailing address

5920 Evergreen Way
Ste E
Everett, WA 98203-6005
Phone (425) 353-4884

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
I20161118001315 WA Practitioner - Oral Surgery 1850670654 Practice locations: Everett, WA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE00007785WAMDProsthodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Craig Pearce DMD PLLC CurrentSince Oct 8, 2016 Accepting new patients
Ekaterina Malinovska DDS PLLC Past Accepting new patients

Locations

5920 Evergreen Way
Ste E
Everett, WA 98203
Phone (425) 353-4884

Organizations & group practices 2

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730182536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 EVERGREEN WAY",
            "address_2": "STE E",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036005",
            "telephone_number": "425-353-4884",
            "fax_number": "425-353-6197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 EVERGREEN WAY",
            "address_2": "STE E",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036005",
            "telephone_number": "425-353-4884",
            "fax_number": "425-353-6197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARCE",
        "first_name": "CRAIG",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "WA",
            "license": "DE00007785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.