Active NPI
Alison Raeann Smith, D.D.S.
- Dentist
- Bellevue, WA
National Provider Identifier
1871948406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DE60765345
- Practice address
- 12917 SE 38TH St Ste 202
Bellevue, WA 98006-1349 - Phone
- (425) 747-8052
- Fax
- (425) 562-7222
- NPI assigned
- May 2, 2016
- Last updated
- Oct 16, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DE60765345 | WA | Primary |
Addresses
Primary practice location
12917 SE 38TH St Ste 202
Bellevue, WA 98006-1349
Mailing address
12917 SE 38TH St Ste 202
Bellevue, WA 98006-1349
Phone (425) 747-8052
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160816000970 | WA | Order and Referring Only - Dentist | 5193019057 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark L Dire DDS P.S. | Past | Accepting new patients |
Interoperability endpoints
- asmith289529@direct.ochin.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Bellevue, WA
- NPI 1164529301
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508112000000",
"number": "1871948406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12917 SE 38TH ST STE 202",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980061349",
"telephone_number": "425-747-8052",
"fax_number": "425-562-7222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12917 SE 38TH ST STE 202",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980061349",
"telephone_number": "425-747-8052",
"fax_number": "425-562-7222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "ALISON",
"middle_name": "RAEANN",
"name_prefix": "Miss",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-02",
"last_updated": "2017-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "DE60765345",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2017; 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.