Individual provider Active NPI

Nicholas Jon Forsythe, DMD

  • General Practice Dentistry
  • Arlington, WA
National Provider Identifier
1760977854
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE60850654 Issued in WA
Practice address
16825 Smokey Point Blvd
Arlington, WA 98223-8407
Phone
(360) 653-5197
NPI assigned
Jun 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE60850654 WA Primary

Addresses

Primary practice location

16825 Smokey Point Blvd
Arlington, WA 98223-8407

Mailing address

11302 4TH Ave NE
Tulalip, WA 98271-9446
Phone (425) 870-8546

Other practice location 1

16825 Smokey Point Blvd
Arlington, WA 98223-8407
Phone (360) 653-5197

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

LicenseStateTypeSpecialty
DE60850654WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kim and Lee, DMDS, PLLC PastSince Sep 1, 2024 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1760977854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11302 4TH AVE NE",
            "city": "TULALIP",
            "state": "WA",
            "postal_code": "982719446",
            "telephone_number": "425-870-8546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16825 SMOKEY POINT BLVD",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982238407",
            "telephone_number": "360-653-5197"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16825 Smokey Point Blvd",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "WA",
            "postal_code": "982238407",
            "country_code": "US",
            "telephone_number": "360-653-5197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORSYTHE",
        "first_name": "NICHOLAS",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-29",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60850654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.