James Bayard Dubois, D.D.S., P.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4845 Issued in WA

Practice address

121 Kennebeck Ave N
Kent, WA 98030-4621

Phone

(253) 854-6300

Fax

(253) 854-9976

NPI assigned

Oct 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Aesthetic and General Dentistry

  • General Practice Dentistry
  • Kent, WA
  • NPI 1437605979
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740378504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 KENNEBECK AVE N",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980304621",
            "telephone_number": "253-854-6300",
            "fax_number": "253-854-9976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 KENNEBECK AVE N",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980304621",
            "telephone_number": "253-854-6300",
            "fax_number": "253-854-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOIS",
        "first_name": "JAMES",
        "middle_name": "BAYARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S., P.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "4845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Romero P.S., Inc.
• Dr. Vyacheslav a. Borisenko, D.C., P.S. (NW Spinal Rehabilitation Clinic)
• Philip Drasny, BCBA
• Kaitlin Dresdner, BCBA
• Fartun A Duale
• Matthew Julian Duenas, MD
• Deanne Lorraine Duff, LMP, RC
• Diane Dufner Sanders, ARNP
• Affing Dukuly
• Angela Duncan

• General Practice Dentistry in Kent, WA
• Providers in Kent, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.