Active NPI
Michael Joseph Conway, D.D.S.
- General Practice Dentistry
- Kenmore, WA
National Provider Identifier
1912004037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7496
- Practice address
- 5723 NE Bothell Way
Suite B
Kenmore, WA 98028-9404 - Phone
- (425) 485-0588
- Fax
- (425) 483-6189
- NPI assigned
- Sep 20, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7496 | WA | Primary |
Addresses
Primary practice location
5723 NE Bothell Way
Suite B
Kenmore, WA 98028-9404
Mailing address
5723 NE Bothell Way
Suite B
Kenmore, WA 98028-9404
Phone (425) 485-0588
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20-0202013 | Other | FEDERAL TAX ID | |
| 7496 | Other | WA | DENTAL LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7496 | WA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael Conway DDS PLLC | General Practice | Past | Accepting new patients |
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": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912004037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5723 NE BOTHELL WAY",
"address_2": "SUITE B",
"city": "KENMORE",
"state": "WA",
"postal_code": "980289404",
"telephone_number": "425-485-0588",
"fax_number": "425-483-6189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5723 NE BOTHELL WAY",
"address_2": "SUITE B",
"city": "KENMORE",
"state": "WA",
"postal_code": "980289404",
"telephone_number": "425-485-0588",
"fax_number": "425-483-6189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONWAY",
"first_name": "MICHAEL",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "7496",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL TAX ID",
"identifier": "20-0202013",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE",
"identifier": "7496",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kenmore, WA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.