Preston John Dekker, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DE61485147 Issued in WA

Practice address

15421 Main St Ste 101
Mill Creek, WA 98012-9002

Phone

(425) 336-1894

NPI assigned

Feb 23, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Dec 6, 2022 through Dec 6, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Holtzen & Johnson, LTD

  • Specialist
  • Las Vegas, NV
  • NPI 1447346226
  NPD (past)
• Omfs Surgery Center, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Las Vegas, NV
  • NPI 1043573553
  NPD (past)

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

{
    "created_epoch": "1519344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1962903112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 1ST ST S",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336528",
            "telephone_number": "480-313-7636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15421 MAIN ST STE 101",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980129002",
            "telephone_number": "425-336-1894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2902 164th St SW Ste C1",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980873201",
            "country_code": "US",
            "telephone_number": "425-381-4975",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 2nd Ave",
            "address_purpose": "LOCATION",
            "city": "Long Branch",
            "state": "NJ",
            "postal_code": "077406395",
            "country_code": "US",
            "telephone_number": "732-222-5200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "224 36th St",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "982256540",
            "country_code": "US",
            "telephone_number": "360-474-4390",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "305 SE Everett Mall Way Ste 18",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982083250",
            "country_code": "US",
            "telephone_number": "425-654-1264",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "535 Broadway E",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981025023",
            "country_code": "US",
            "telephone_number": "206-829-4333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5900 15th Ave NW",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981073008",
            "country_code": "US",
            "telephone_number": "206-388-5391",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13317 NE 175th St Ste AA",
            "address_purpose": "LOCATION",
            "city": "Woodinville",
            "state": "WA",
            "postal_code": "980726815",
            "country_code": "US",
            "telephone_number": "425-321-5614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "324 E College Way Ste 101",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982735473",
            "country_code": "US",
            "telephone_number": "360-610-4129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3943 116th St NE Ste 103",
            "address_purpose": "LOCATION",
            "city": "Marysville",
            "state": "WA",
            "postal_code": "982718448",
            "country_code": "US",
            "telephone_number": "360-284-4632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEKKER",
        "first_name": "PRESTON",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-23",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NJ",
            "license": "22DI03148100",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.031837",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE61485147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl De Roca, M.A., M.S.
• Holly D Debevoise
• Kristin Dedeaux, D.C.
• Karen Mitrakul Deguzman
• Jason Patrick Dekema
• Jenifer Rae Denormandie
• Lisa Ann Depietto
• Dion Richard Di Blasi, OD
• Diana Diamond, LMT
• Jennifer Tumamao Domingo, RN

• Oral and Maxillofacial Surgery (Dentist) in Mill Creek, WA
• Providers in Mill Creek, WA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.