Pakwan Varapongsittikul, DDS, MS, FACP

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DE61094825 Issued in WA

Practice address

2505 S 320TH St Ste 110
Federal Way, WA 98003-5461

Phone

(206) 992-7332

NPI assigned

Nov 19, 2020

Sex

Female

Sole proprietor

No

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1841893906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 S 320TH ST STE 110",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035461",
            "telephone_number": "206-992-7332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 S 320TH ST STE 110",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035461",
            "telephone_number": "206-992-7332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 NE 45th St Apt 236",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981056162",
            "country_code": "US",
            "telephone_number": "206-992-7332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VARAPONGSITTIKUL",
        "first_name": "PAKWAN",
        "credential": "DDS, MS, FACP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-19",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "WA",
            "license": "DE61094825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Jo Vandebrake, P.T.A.
• Peter Forber Vanderven, PLLC
• Camille Marie Vandevanter, DDS, MSD
• Vivian Vaninwegen
• Dedric Vann
• Eduardo Varela, MSN FNP-C
• John Varkey
• Eric Scott Varley, D O
• Jessicca Rae Varnum, MSW, LSWAIC
• Zubin Vasavada, MD

• Prosthodontics in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Prosthodontics in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.