Individual provider Active NPI

Elizabeth A Palmer, DMD, MS

  • Pediatric Dentistry
  • Seattle, WA
National Provider Identifier
1801042163
Registry record updated Sep 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DE60448641 Issued in WA
Practice address
6222 NE 74TH St # 354915
The Center for Pediatric Dentistry
Seattle, WA 98115-8158
Phone
(206) 543-5800
Fax
(206) 543-0063
NPI assigned
Aug 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X D9211 OR
Pediatric Dentistry 1223P0221X DE60448641 WA Primary

Addresses

Primary practice location

6222 NE 74TH St # 354915
The Center for Pediatric Dentistry
Seattle, WA 98115-8158

Mailing address

6222 NE 74TH St # 354915
The Center for Pediatric Dentistry
Seattle, WA 98115-8158
Phone (206) 543-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20110113000898 OR Practitioner - Oral Surgery 8628267168 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DE60448641WAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
University Professional Services CurrentSince Jul 1, 2018 Accepting new patients
University Professional Services Current Accepting new patients
University Professional Services CurrentSince Jul 1, 2018 Accepting new patients

Locations

15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

Interoperability endpoints

  • Direct secure messaging: epalmerdmd16872@direct.ohsu.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409702400000",
    "number": "1801042163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6222 NE 74TH ST # 354915",
            "address_2": "THE CENTER FOR PEDIATRIC DENTISTRY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981158158",
            "telephone_number": "206-543-5800",
            "fax_number": "206-543-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6222 NE 74TH ST # 354915",
            "address_2": "THE CENTER FOR PEDIATRIC DENTISTRY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981158158",
            "telephone_number": "206-543-5800",
            "fax_number": "206-543-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-18",
        "last_updated": "2014-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OR",
            "license": "D9211",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE60448641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.