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NPI 1477411692ActiveIndividual· Dentist· Kent, WA

Dentist in Kent, Washington, licensed in WA, with an NPI issued in January 2026.

Overview

NPI1477411692
StatusActive
Entity typeIndividual
Sole proprietorNo
NPI issuedJan 15, 2026
Last updated in NPPESOct 15, 2026
Certified by providerOct 15, 2026

Specialties and licenses

TaxonomyCodeLicenseState
Dentist Primary122300000XDENT.DE.70175480WA

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Industry payments (Open Payments)

None reported for 2025 or 2024.

Receiving payments does not imply wrongdoing. What Open Payments covers ·original records

Other dentists in Kent

All 60 dentists in Kent · All dentists in Washington