Individual provider Active NPI

Andre-David Kahwach, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Seattle, WA
National Provider Identifier
1912446774
Registry record updated Sep 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
DR60753080 Issued in WA
Practice address
University of Washington Department of Oral
1959 NE Pacific Street
Seattle, WA 98195-0001
Phone
(415) 997-0004
NPI assigned
Feb 13, 2017
Last updated
Sep 12, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X DR60753080 WA Primary

Addresses

Primary practice location

University of Washington Department of Oral
1959 NE Pacific Street
Seattle, WA 98195-0001

Mailing address

Dept. of Oral & Maxillofacial Surgey
1959 NE Pacific Street, Box 357134
Seattle, WA 98195
Phone (424) 232-6356

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

Interoperability endpoints

  • Direct secure messaging: akahwach337160@direct.llu.edu

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505174400000",
    "number": "1912446774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT. OF ORAL & MAXILLOFACIAL SURGEY",
            "address_2": "1959 NE PACIFIC STREET, BOX 357134",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98195",
            "telephone_number": "424-232-6356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF WASHINGTON DEPARTMENT OF ORAL",
            "address_2": "1959 NE PACIFIC STREET",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "415-997-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHWACH",
        "first_name": "ANDRE-DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "WA",
            "license": "DR60753080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2017; 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.