Individual provider Active NPI

Matt A Pilot, DDS

  • General Practice Dentistry
  • Bellevue, WA
National Provider Identifier
1801970371
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6495 Issued in WA
Practice address
5611 119TH Ave SE
Suite #2
Bellevue, WA 98006-3799
Phone
(425) 746-6554
Fax
(425) 746-0145
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6495 WA Primary

Addresses

Primary practice location

5611 119TH Ave SE
Suite #2
Bellevue, WA 98006-3799

Mailing address

5611 119TH Ave SE
Suite #2
Bellevue, WA 98006-3799
Phone (425) 746-6554

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20160205001382 WA Order and Referring Only - DentistPractitioner - Dentist 1052615309

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6495WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Newport Hills Dental General Practice Past Accepting new patients

Organizations & group practices 1

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801970371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5611 119TH AVE SE",
            "address_2": "SUITE #2",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980063799",
            "telephone_number": "425-746-6554",
            "fax_number": "425-746-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5611 119TH AVE SE",
            "address_2": "SUITE #2",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980063799",
            "telephone_number": "425-746-6554",
            "fax_number": "425-746-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PILOT",
        "first_name": "MATT",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "6495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.