Active NPI
Dania Mustafa
- Dentist
- Vancouver, WA
National Provider Identifier
1730879305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DENT.DE.70019265
- Practice address
- 900 SE Chkalov Dr
Vancouver, WA 98683-5240 - Phone
- (360) 997-0626
- NPI assigned
- May 8, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 | DENT.DE.70019265 | WA | Primary |
Addresses
Primary practice location
900 SE Chkalov Dr
Vancouver, WA 98683-5240
Mailing address
4071 Lee Rd Ste 260
Cleveland, OH 44128-2173
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251008002798 | WA | Order and Referring Only - Dentist | 9032616727 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DENT.DE.70019265 | WA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781654400000",
"number": "1730879305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4071 LEE RD STE 260",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441282173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 SE CHKALOV DR",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986835240",
"telephone_number": "360-997-0626"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUSTAFA",
"first_name": "DANIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-08",
"last_updated": "2026-06-17",
"certification_date": "2026-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DENT.DE.70019265",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.