Active NPI
Peter Paul Mpantas, D.M.D.
- General Practice Dentistry
- Seattle, WA
National Provider Identifier
1932518206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 60466844
- Practice address
- 2641 42ND Ave SW
Apt 317
Seattle, WA 98116-4901 - Phone
- (516) 984-9129
- NPI assigned
- Aug 11, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 60466844 | WA | |
| General Practice Dentistry | 1223G0001X | 60466844 | WA | Primary |
Addresses
Primary practice location
2641 42ND Ave SW
Apt 317
Seattle, WA 98116-4901
Mailing address
2641 42ND Ave SW
Apt 317
Seattle, WA 98116-4901
Phone (516) 984-9129
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 15, 2020 through Oct 15, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60466844 | WA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Picasso Dental Az | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Mesa, AZ
- NPI 1326110024
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407715200000",
"number": "1932518206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2641 42ND AVE SW",
"address_2": "APT 317",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981164901",
"telephone_number": "516-984-9129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2641 42ND AVE SW",
"address_2": "APT 317",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981164901",
"telephone_number": "516-984-9129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MPANTAS",
"first_name": "PETER",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-11",
"last_updated": "2014-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WA",
"license": "60466844",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "60466844",
"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 Aug 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.