Individual provider Active NPI

Yessica Yasmin Gaxiola

  • Dental Assistant
  • Lynnwood, WA
National Provider Identifier
1831680974
Registry record updated May 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AssistantTaxonomy code 126800000X
License
GAXIOYY049OJ Issued in WA
Practice address
17425 Wa-99 Suite D
Lynnwood, WA 98037
Phone
(425) 329-7259
NPI assigned
May 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Assistant 126800000X GAXIOYY049OJ WA Primary

Addresses

Primary practice location

17425 Wa-99 Suite D
Lynnwood, WA 98037

Mailing address

17425 Wa-99 Suite D
Lynnwood, WA 98037
Phone (206) 519-9598

Other practice location 1

901 E Marine View Dr Unit 206
Everett, WA 98201-1438
Phone (206) 519-9598

Other identifiers 1

IdentifierTypeStateIssuer
GAXIOYY049OJMedicaidWA

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
GAXIOYY049OJWAMDDental Assistant

NPI Registry JSON

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1831680974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17425 WA-99 SUITE D",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "98037",
            "telephone_number": "206-519-9598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17425 WA-99 SUITE D",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "98037",
            "telephone_number": "425-329-7259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 E Marine View Dr Unit 206",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982011438",
            "country_code": "US",
            "telephone_number": "206-519-9598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAXIOLA",
        "first_name": "YESSICA",
        "middle_name": "YASMIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-24",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "WA",
            "license": "GAXIOYY049OJ",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GAXIOYY049OJ",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; 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.