Kozue Kawakubo, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DE60587893 Issued in WA

Practice address

17130 Avondale Way NE
Suite 118
Redmond, WA 98052-4455

Phone

(425) 869-1830

NPI assigned

Dec 21, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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.

• David R. Atherton DDS PLLC

  • Pediatric Dentistry
  • Redmond, WA
  • NPI 1316239098
  NPD (past)
• Sadler Dental PLLC

  • Pediatric Dentistry
  • Redmond, WA
  • NPI 1821652546
  NPD (past)

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

{
    "created_epoch": "1261353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1780913764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17130 AVONDALE WAY NE",
            "address_2": "SUITE 118",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980524455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17130 AVONDALE WAY NE",
            "address_2": "SUITE 118",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980524455",
            "telephone_number": "425-869-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAWAKUBO",
        "first_name": "KOZUE",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-21",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "15250",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE60587893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Ostler PLLC
• Roozbeh Katiraie
• Aarti Katyal, PT
• Gulsheen Kaur, OD
• Gursirat Kaur, BCBA
• Parandis Kazemi, DDS
• KB Massage Studio, PLLC
• Carla Marie Keats, CCC-SLP
• Kee and Kee PLLC
• Richard Keeler, MD

• Pediatric Dentistry in Redmond, WA
• Providers in Redmond, WA by specialty
• Pediatric Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2021; 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.