Individual provider Active NPI

Camran Saied Zafarnia, D.D.S

  • General Practice Dentistry
  • Kikland, WA
National Provider Identifier
1891919775
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00007384 Issued in WA
Practice address
12819 120TH Ave NE
Suite I
Kikland, WA 98034
Phone
(425) 803-0400
Fax
(425) 803-3368
NPI assigned
Apr 12, 2007
Last updated
Jun 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE00007384 WA Primary

Addresses

Primary practice location

12819 120TH Ave NE
Suite I
Kikland, WA 98034

Mailing address

12819 120TH Ave NE
Suite I
Kikland, WA 98034
Phone (425) 803-0400

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
DE00007384WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Dental Clinic Current Accepting new patients

Locations

12819 120th Ave NE
Ste I
Kirkland, WA 98034
Phone (425) 803-0400

Organizations & group practices 2

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": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1891919775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12819 120TH AVE NE",
            "address_2": "SUITE I",
            "city": "KIKLAND",
            "state": "WA",
            "postal_code": "98034",
            "telephone_number": "425-803-0400",
            "fax_number": "425-803-3368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12819 120TH AVE NE",
            "address_2": "SUITE I",
            "city": "KIKLAND",
            "state": "WA",
            "postal_code": "98034",
            "telephone_number": "425-803-0400",
            "fax_number": "425-803-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAFARNIA",
        "first_name": "CAMRAN",
        "middle_name": "SAIED",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00007384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2014; 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.