Individual provider Active NPI

Ekaterina Malinovska, D.D.S.

  • Dentist
  • Shoreline, WA
National Provider Identifier
1912328758
Registry record updated Dec 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60421620 Issued in WA
Practice address
1359 N 205TH St Ste a
Bright 32 Family Dentistry
Shoreline, WA 98133-3215
Phone
(206) 533-9693
Fax
(206) 533-9691
NPI assigned
Dec 20, 2013
Last updated
Dec 20, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE60421620 WA Primary

Addresses

Primary practice location

1359 N 205TH St Ste a
Bright 32 Family Dentistry
Shoreline, WA 98133-3215

Mailing address

1359 N 205TH St Ste a
Bright 32 Family Dentistry
Shoreline, WA 98133-3215
Phone (206) 533-9693

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
I20160825000966 WA Order and Referring Only - DentistPractitioner - Other (Physician)Practitioner - Dentist 4486949740

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jordan Brenner DDS, PLLC 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": "1387497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387497600000",
    "number": "1912328758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1359 N 205TH ST STE A",
            "address_2": "BRIGHT 32 FAMILY DENTISTRY",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981333215",
            "telephone_number": "206-533-9693",
            "fax_number": "206-533-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1359 N 205TH ST STE A",
            "address_2": "BRIGHT 32 FAMILY DENTISTRY",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981333215",
            "telephone_number": "206-533-9693",
            "fax_number": "206-533-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALINOVSKA",
        "first_name": "EKATERINA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-20",
        "last_updated": "2013-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60421620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

Verify at the official NPI Registry.