Individual provider Active NPI

Jessica Hsu

  • Periodontics
  • Kirkland, WA
National Provider Identifier
1922632843
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DE61017009 Issued in WA
Practice address
625 4TH Ave Ste 201
Kirkland, WA 98033-9028
Phone
(281) 731-3733
NPI assigned
Feb 29, 2020
Last updated
Aug 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DE61017009 WA Primary

Addresses

Primary practice location

625 4TH Ave Ste 201
Kirkland, WA 98033-9028

Mailing address

625 4TH Ave Ste 201
Kirkland, WA 98033-9028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 13, 2021 through Jul 13, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DE61017009WAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Jessica C Hsu DDS PLLC Periodontics CurrentSince Oct 11, 2020 Accepting new patients
Jessica C Hsu DDS PLLC Periodontics CurrentSince Mar 9, 2020 Accepting new patients

Locations

625 4th Ave
Ste 201
Kirkland, WA 98033
Phone (281) 731-3733

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": "1582934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1922632843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 4TH AVE STE 201",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980339028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 4TH AVE STE 201",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980339028",
            "telephone_number": "281-731-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HSU",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-29",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": "DE61017009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.