Individual provider Active NPI

Syeda Bakhtawar, DMD

  • General Practice Dentistry
  • Bellevue, WA
National Provider Identifier
1780968065
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE60238596 Issued in WA
Practice address
188 - 106TH Ave NE
#410
Bellevue, WA 98004
Phone
(425) 454-2005
Fax
(425) 454-1360
NPI assigned
Oct 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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 DE60238596 WA Primary

Addresses

Primary practice location

188 - 106TH Ave NE
#410
Bellevue, WA 98004

Mailing address

188 - 106TH Ave NE
#410
Bellevue, WA 98004
Phone (425) 454-2005

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170201000952 WA Order and Referring Only - DentistPractitioner - Dentist 0446533244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Syeda Bakhtawar DMD PLLC Current Accepting new patients
Donald J. Soltero, DDS Past Accepting new patients

Locations

188 106th Ave NE
Ste 410
Bellevue, WA 98004
Phone (425) 454-2005

Organizations & group practices 2

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": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1780968065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 - 106TH AVE NE",
            "address_2": "#410",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-454-2005",
            "fax_number": "425-454-1360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 - 106TH AVE NE",
            "address_2": "#410",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-454-2005",
            "fax_number": "425-454-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKHTAWAR",
        "first_name": "SYEDA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-05",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60238596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.