Kitsap OMS – Oral & Maxillofacial Surgery (D.M.D.), NPI 1467655548
Oral & Maxillofacial Surgery (D.M.D.)
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Kitsap OMS
PO BOX 3770
SILVERDALE, WA 98383
Phone: (360) 698-9335
Fax: (360) 698-9385
Type: Mailing
Kitsap OMS, 19503, 7th Avenue Northeast, Poulsbo, Kitsap County, Washington, 98370, United States
POULSBO, WA 98370
Phone: (360) 779-2339
Fax: (360) 779-6475
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-03-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-07-31 (314 days ago).
Enrollment records
1
Earliest due date
2025-07-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040309000372 | O | Clinic/Group Practice | WA | 2025-07-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98383)
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