Michael Beverly Washington, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4463 Issued in WA

Practice address

4543 Rainier Ave S
Seattle, WA 98118-1656

Phone

(206) 722-8211

Fax

(206) 722-3249

NPI assigned

Mar 12, 2007

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Kelley M. Washington DDS,PS

  • Dental Clinic/Center
  • Seattle, WA
  • NPI 1174826937
  NPD (past)

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780716985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4543 RAINIER AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981181656",
            "telephone_number": "206-722-8211",
            "fax_number": "206-722-3249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4543 RAINIER AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981181656",
            "telephone_number": "206-722-8211",
            "fax_number": "206-722-3249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "MICHAEL",
        "middle_name": "BEVERLY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "4463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON DENTAL SERVICE",
            "identifier": "5517",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55157-05",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah L. Washington, M.D.
• Goldie Elizabeth Washington, LICSW, MSW
• Kathleen A. Washington, PH.D
• Kelley Michael Washington, DDS
• Michael Washington
• Rolanda Washington
• Sade P Washington
• Shanece Washington, AU.D., MPH
• Susan Washington, RN
• Tonia Washington

• General Practice Dentistry in Seattle, WA
• Providers in Seattle, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.