Justin M Pagan, D.D.S., M.S.D.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DE00010404 Issued in WA

Practice address

21807 76TH Ave W
Edmonds, WA 98026-7938

Phone

(425) 775-3564

NPI assigned

Oct 11, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790874758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21807 76TH AVE W",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267938",
            "telephone_number": "425-775-3564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21807 76TH AVE W",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267938",
            "telephone_number": "425-775-3564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGAN",
        "first_name": "JUSTIN",
        "middle_name": "M",
        "credential": "D.D.S., M.S.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "DE00010404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Ozanich, LMP
• Pacific Healthcare, LLC
• Pacific Mental Health
• Pacific Nutrition & Wellness
• Pacific Vascular Incorporated (Pacific Vascular-Edmonds)
• Michael John Pagan, PT
• Pain Care, Inc.
• Paisano Physical Therapy Services, Inc.
• Paktia Pharmacy LLC (paktia pharmacy)
• Yaoji Pan

• Orthodontics and Dentofacial Orthopedics Dentistry in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Orthodontics and Dentofacial Orthopedics 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.