Unknown Individual – Periodontics, NPI 1689713885

Unknown Individual is a healthcare provider. based in Vancouver, Washington. specializing in Periodontics. They hold a License No. DE0006024 (WA). The NPI Number for Unknown Individual is 1689713885

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1689713885
Phone
(360) 253-9792
Address
406 SE 131ST AVE
Deactivation Date
12 June 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 406 SE 131ST AVE

    STE 305C

    VANCOUVER, WA 986834004

    Phone: (360) 253-9792

    Fax: (360) 604-5266

    Mailing address matches the actual address.

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.

No Medicare enrollment or revalidation data available for this provider in our database.

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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 98683)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1689713885 on file in the registry.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Periodontics. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Vancouver?
Public fields place Unknown Individual around Vancouver, Washington. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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