Unknown Individual – Periodontics, NPI 1790877389

Unknown Individual is a healthcare provider. based in Seattle, Washington. specializing in Periodontics. They hold a License No. 7990 (WA). The NPI Number for Unknown Individual is 1790877389

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1790877389
Phone
(206) 625-9358
Address
720 OLIVE WAY
Deactivation Date
20 July 2022
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

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Provider Addresses for Unknown Individual

  • Market Fresh, 720, Olive Way, Central Business District, First Hill, Seattle, King County, Washington, 98101, United States

    #610

    SEATTLE, WA 981011878

    Phone: (206) 625-9358

    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 98101)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1790877389 as the unique 10-digit identifier.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Periodontics. Clinical services aligned with this taxonomy classification.
Where in Washington is Unknown Individual registered?
Use Seattle, Washington as the headline location for Unknown Individual here.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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