FRED EBSWORTH DDS PS
NPI 1104061969
Clinic/Center - Dental in Lake Forest Park, WA

NPI Status: Active since December 09, 2008

Contact Information

17191 BOTHELL WAY NE
SUITE 201
LAKE FOREST PARK, WA
ZIP 98155
Phone: (206) 362-0152
Fax: (206) 365-3441

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  • Organization
  • Clinic/Center
  • Dental

About FRED EBSWORTH DDS PS

This page provides the complete NPI Profile along with additional information for Fred Ebsworth Dds Ps, a provider established in Lake Forest Park, Washington operating as a Clinic/center, focusing in dental . The healthcare provider is registered in the NPI registry with number 1104061969 assigned on December 2008. The practitioner's primary taxonomy code is 261QD0000X with license number DE00004073 (WA). The provider is registered as an organization and their NPI record was last updated 18 years ago. The authorized official of this NPI record is Dr. Charles F Ebsworth Dds (President)

NPI
1104061969
Provider Name
FRED EBSWORTH DDS PS
Entity Type
Organization
Location Address
17191 BOTHELL WAY NE SUITE 201 LAKE FOREST PARK, WA 98155
Location Phone
(206) 362-0152
Location Fax
(206) 365-3441
Mailing Address
17191 BOTHELL WAY NE SUITE 201 LAKE FOREST PARK, WA 98155
Mailing Phone
(206) 362-0152
Mailing Fax
(206) 365-3441
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-09-2008
Last Update Date
12-09-2008
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Dental

Taxonomy Code
261QD0000X
Type
Ambulatory Health Care Facilities
License No.
DE00004073
License State
WA

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. CHARLES F EBSWORTH DDS

Authorized Official Title
PRESIDENT
Authorized Official Phone
(206) 362-0152

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1104061969, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
0
Doubled → 0
Pos 4
4
Unchanged
Pos 5
0
Doubled → 0
Pos 6
6
Unchanged
Pos 7
1
Doubled → 2
Pos 8
9
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 0 → 0 1 → 2 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 0 + 4 + 0 + 6 + 2 + 9 + 1 + 2 + 24 = 51

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 51 is 60. The difference is the calculated check digit.

60 - 51 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1104061969.

Other Providers at the Same Location


The following 14 providers are registered at the same or a nearby location.

Family Medicine
17191 BOTHELL WAY NE, SUITE 205
LAKE FOREST PARK, WA 98155
Family Medicine
17191 BOTHELL WAY NE, STE 205
LAKE FOREST PARK, WA 98155
Family Medicine
17191 BOTHELL WAY NE, STE 205
LAKE FOREST PARK, WA 98155
Neuromusculoskeletal Medicine & OMM
17191 BOTHELL WAY NE, SUITE 205
LAKE FOREST PARK, WA 98155
Family Medicine
17191 BOTHELL WAY NE
LAKE FOREST PARK, WA 98155
Dentist (General Practice)
17191 BOTHELL WAY NE, SUITE 201
LAKE FOREST PARK, WA 98155
Physician Assistant
17191 BOTHELL WAY NE
LAKE FOREST PARK, WA 98155
Nurse Practitioner (Family)
17191 BOTHELL WAY NE, SUITE 205
LAKE FOREST PARK, WA 98155
Clinic/Center (Physical Therapy)
17191 BOTHELL WAY NE, SUITE B203
LAKE FOREST PARK, WA 98155
Family Medicine
17191 BOTHELL WAY NE, SUITE 205
LAKE FOREST PARK, WA 98155
Nurse Practitioner (Family)
17191 BOTHELL WAY NE
LAKE FOREST PARK, WA 98155
Internal Medicine
17191 BOTHELL WAY NE, SUITE 205
LAKE FOREST PARK, WA 98155
Family Medicine
17191 BOTHELL WAY NE, SUITE 205
LAKE FOREST PARK, WA 98155
Nurse Practitioner (Family)
17191 BOTHELL WAY NE
LAKE FOREST PARK, WA 98155

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104061969, enumerated as an "organization" on December 09, 2008.

The provider is located at 17191 BOTHELL WAY NE SUITE 201 LAKE FOREST PARK, WA 98155 and the phone number is (206) 362-0152.

Clinic/Center with taxonomy code 261QD0000X and a focus in Dental.