NPIMap

Individual provider Active NPI

Ken Micheal Akimoto, DDS

  • Periodontics
  • Issaquah, WA
National Provider Identifier
1992811541
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
9198 Issued in WA
Practice address
22516 SE 64TH PL
Suite 250
Issaquah, WA 98027-5379
Phone
(425) 392-8992
Fax
(425) 392-0184
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 9198 WA Primary

Addresses

Primary practice location

22516 SE 64TH PL
Suite 250
Issaquah, WA 98027-5379

Mailing address

22516 SE 64TH PL
Suite 250
Issaquah, WA 98027-5379
Phone (425) 392-8992

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9198WAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Ken Akimoto DDS MSD PLLC Periodontics Past Accepting new patients
Implant & Periodontic Specialists Periodontics Past Accepting new patients
Neal C Raval DDS MSD PS Inc Periodontics Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1992811541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22516 SE 64TH PL",
            "address_2": "SUITE 250",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275379",
            "telephone_number": "425-392-8992",
            "fax_number": "425-392-0184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22516 SE 64TH PL",
            "address_2": "SUITE 250",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275379",
            "telephone_number": "425-392-8992",
            "fax_number": "425-392-0184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AKIMOTO",
        "first_name": "KEN",
        "middle_name": "MICHEAL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": "9198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.