Dakita Mack, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

5151013499 Issued in MI

Practice address

626 120TH Ave NE Ste B201
Bellevue, WA 98005-3038

Phone

(425) 453-9060

NPI assigned

Jun 4, 2019

Sex

Female

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1801454871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6341 DESHONG DR",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300586117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 120TH AVE NE STE B201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980053038",
            "telephone_number": "425-453-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "DAKITA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5151013499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Mach, RD
• Tu Mach, EAMP
• Deborah Jane Machin, LMP
• Susan Bancroft Machuca, LMP
• Erika Valeria Macias Hernandez
• Micah James Roland Mack, DO
• Shari Mackay
• Kathryn Anne Mackey, L.M.P.
• Kristin Sara Mackinnon, LICSW
• Heather L Maclean, LMP

• Surgery Physician in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.