Robert Kay Andelin, DDS
Individual provider Active NPI General Practice Dentistry · Pasco, WA
NPI 1831286285 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1831286285
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DE00005210 (WA)
- Practice address
- 1921 W Sylvester St
Pasco, WA 99301-4850 - Phone
- (509) 547-1791
- Fax
- (509) 547-4383
- NPI assigned
- Oct 6, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161027001441 | WA | Order and Referring Only - Dentist |
4082992979 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Robert P. Andelin, DDS, PS | General Practice | Past | Accepting new patients |
| Robert K Andelin DDS PS | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DE00005210 | WA | Yes |
Addresses
Primary practice location
1921 W Sylvester St
Pasco, WA 99301-4850
Mailing address
1921 W Sylvester St
Pasco, WA 99301-4850
Phone (509) 547-1791
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5551106 | Medicaid | WA |
Other providers in Pasco, WA
- Brian Mark Almond
- Jesus L Alvarez
- Joshua F Alvarez
- Nataly Alvarez
- American Hospitalists Inc
- Robert Paul Andelin
- Chad Eric Anderson
- Dallin Curtis Anderson
- Jeremy James Anderson
- Jo Ann Andrade
All providers in Pasco, WA · General Practice Dentistry in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.