Eric Weller, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8485 Issued in WA

Practice address

22833 Bothell Everett Hwy
Suite 205
Bothell, WA 98021-9385

Phone

(425) 485-6540

NPI assigned

Apr 16, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Petersen and Weller DDS PLLC

  • General Practice Dentistry
  • Bothell, WA
  • NPI 1417960782
  NPD (past)

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861617615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16912 RIVER ROCK DR",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980376959",
            "telephone_number": "425-308-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22833 BOTHELL EVERETT HWY",
            "address_2": "SUITE 205",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980219385",
            "telephone_number": "425-485-6540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLER",
        "first_name": "ERIC",
        "name_prefix": "Mr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "8485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anastasia Weber
• Tani Mae Weber, RDH
• Michelle Weible, BCBA, LBA
• Emilie Bunderson Weigel, MD
• Kyla Welch-Heaney, LBA
• Barbara Davis Wells
• Natalie Wells
• Wellseniors PT, PLLC
• Margaret Louise Wencel, DDS
• Michelle C Wendt, DPT

• General Practice Dentistry in Bothell, WA
• Providers in Bothell, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.