Individual provider Active NPI

Alison Raeann Smith, D.D.S.

  • Dentist
  • Bellevue, WA
National Provider Identifier
1871948406
Registry record updated Oct 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60765345 Issued in WA
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, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160816000970 WA Order and Referring Only - DentistPractitioner - Dentist 5193019057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mark L Dire DDS P.S. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.