NPIMap

Organization Active NPI

Dodobaras,D.D.S.,P.S.

  • General Practice Dentistry
  • Federal Way, WA
National Provider Identifier
1790004869
Registry record updated May 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00003460 Issued in WA
Legal business name
DODOBARAS,D.D.S.,P.S.
Practice address
33515 10TH PL S Ste 12
Federal Way, WA 98003-7300
Phone
(253) 838-9996
Fax
(253) 815-9462
NPI assigned
May 27, 2010
Last updated
May 27, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2010

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

Authorized official

Name
Ms. Shawna Marie Carey
Title
Office Manager
Phone
(253) 838-9996

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DE00003460 WA Primary

Addresses

Primary practice location

33515 10TH PL S Ste 12
Federal Way, WA 98003-7300

Mailing address

33515 10TH PL. S. Suite #12
Federal Way, WA 98003
Phone (253) 838-9996

Other identifiers 2

IdentifierTypeStateIssuer
5044129MedicaidWA
5308804MedicaidWA

National Provider Directory

National Provider Directory

Locations

33515 10th Pl S
Ste 12
Federal Way, WA 98003
Phone (253) 838-9996

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274918400000",
    "number": "1790004869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33515 10TH PL. S. SUITE #12",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "98003",
            "telephone_number": "253-838-9996",
            "fax_number": "253-815-9462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33515 10TH PL S STE 12",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980037300",
            "telephone_number": "253-838-9996",
            "fax_number": "253-815-9462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DODOBARAS,D.D.S.,P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-27",
        "last_updated": "2010-05-27",
        "status": "A",
        "authorized_official_last_name": "CAREY",
        "authorized_official_first_name": "SHAWNA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "253-838-9996",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00003460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5044129",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5308804",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2010; 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.