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Nicholas Parque

Individual provider Active NPI General Practice Dentistry · Seatlle, WA

NPI 1790132041 · NPPES record last updated Oct 16, 2023

Key facts

NPI
1790132041
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
60650656 (WA)
Practice address
4915 25TH Ave NE
Seatlle, WA 98105
Phone
(206) 524-1600
NPI assigned
May 17, 2016
Sex
Male
Sole proprietor
No

Organizations & group practices 3

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
60650656WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Nicholas Parque DDS PLLC General Practice Current Accepting new patients
Peregrine Pacific Anesthesia PLLC Past Accepting new patients
Winston & Letwin DDS, PLLC General Practice Past
since Jul 24, 2022		 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nparque1042889@wm.providencedirect.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 60650656 WA Yes

Addresses

Primary practice location

4915 25TH Ave NE
Seatlle, WA 98105

Mailing address

1200 12TH Ave S Ste 901
Seattle, WA 98144-2712
Phone (206) 548-3114

Other practice location 1

525 Lilly Rd NE Ste 110
Olympia, WA 98506
Phone (206) 548-5850

Other providers in Seatlle, WA

All providers in Seatlle, WA · General Practice Dentistry in Washington

Sources for this page

Verify at the official NPI Registry.