Individual provider Active NPI

Agata Agnieszka Pikula, DDS

  • Dentist
  • Puyallup, WA
National Provider Identifier
1821209297
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401411787 Issued in VA
Practice address
1420 3Rd St SE # 104
Puyallup, WA 98372-3730
Phone
(313) 942-5723
Fax
(253) 697-0201
NPI assigned
May 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 DE60591198 WA
Dentist 122300000X 0401411787 VA Primary

Addresses

Primary practice location

1420 3Rd St SE # 104
Puyallup, WA 98372-3730

Mailing address

1420 3Rd St SE # 104
Puyallup, WA 98372-3730
Phone (313) 942-5723

Other practice location 1

1470 Pantops Mountain Pl
Charlottesville, VA 22911-4600
Phone (434) 817-1817

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401411787VAMDDentist
DE60591198WAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Agata a Pikula DDS PLLC CurrentSince Jul 24, 2022 Accepting new patients

Locations

1420 3rd St SE
Ste 104
Puyallup, WA 98372
Phone (253) 697-0201

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": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1821209297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 3RD ST SE # 104",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723730",
            "telephone_number": "313-942-5723",
            "fax_number": "253-697-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 3RD ST SE # 104",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723730",
            "telephone_number": "313-942-5723",
            "fax_number": "253-697-0201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1470 Pantops Mountain Pl",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229114600",
            "country_code": "US",
            "telephone_number": "434-817-1817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIKULA",
        "first_name": "AGATA",
        "middle_name": "AGNIESZKA",
        "name_prefix": "Ms.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE60591198",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401411787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.