Individual provider Active NPI

Jeffrey Paul Kanter, DDS MS

  • Periodontics
  • Redmond, WA
National Provider Identifier
1922187590
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DE00007354 Issued in WA
Practice address
15955 NE 85TH Street
Suite 205
Redmond, WA 98052-3550
Phone
(425) 895-9575
Fax
(425) 895-9875
NPI assigned
Nov 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DE00007354 WA Primary

Addresses

Primary practice location

15955 NE 85TH Street
Suite 205
Redmond, WA 98052-3550

Mailing address

15955 NE 85TH Street
Suite 205
Redmond, WA 98052-3550
Phone (425) 895-9575

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
I20141008001551 WA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7517187867

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922187590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15955 NE 85TH STREET",
            "address_2": "SUITE 205",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523550",
            "telephone_number": "425-895-9575",
            "fax_number": "425-895-9875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15955 NE 85TH STREET",
            "address_2": "SUITE 205",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523550",
            "telephone_number": "425-895-9575",
            "fax_number": "425-895-9875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANTER",
        "first_name": "JEFFREY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": "DE00007354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

Verify at the official NPI Registry.