Individual provider Active NPI

Negin Nazarian, D.D.S

  • Public Health Dentistry
  • Redmond, WA
National Provider Identifier
1982052973
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
DE60753341 Issued in WA
Practice address
23515 NE Novelty Hill Rd Ste 209
Redmond, WA 98053-5505
Phone
(425) 898-7780
NPI assigned
May 31, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D13674 MN
Public Health Dentistry 1223D0001X DE60753341 WA Primary

Addresses

Primary practice location

23515 NE Novelty Hill Rd Ste 209
Redmond, WA 98053-5505

Mailing address

17190 NE 5TH PL
Bellevue, WA 98008-4132
Phone (206) 327-4136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20161010002214 MN Order and Referring Only - DentistPractitioner - Dentist 8022306976

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D13674MNMDDentist
DE60753341WAMDPublic Health Dentist

NPI Registry JSON

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

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1982052973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17190 NE 5TH PL",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980084132",
            "telephone_number": "206-327-4136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23515 NE NOVELTY HILL RD STE 209",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980535505",
            "telephone_number": "425-898-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZARIAN",
        "first_name": "NEGIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-31",
        "last_updated": "2021-12-20",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13674",
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "WA",
            "license": "DE60753341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

Verify at the official NPI Registry.