SUSAN WILLIS DDS
NPI 1104996131
Dentist - General Practice in Seattle, WA

Q: What is Susan Willis's NPI number?

The NPI number for Susan Willis is 1104996131. It was assigned to this individual provider in the NPPES registry on November 8, 2006.

Q: What is Susan Willis's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Susan Willis was last updated on January 22, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since November 08, 2006PECOS Enrolled

1629 N 45TH ST, SEATTLE, WA 98103(206) 633-3350(206) 633-3113 Get Directions Write a Review

NPPES record last updated: January 22, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

On this page

About Susan Willis Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUSAN WILLIS DDS (NPI 1104996131) is an individual general practice provider in Seattle, Washington, licensed in Washington (DE00009739) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104996131

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameSUSAN WILLISCredential: DDS

Location Address1629 N 45TH STSeattle, WA 98103-6701

Mailing Address1200 12th Ave S, Suite 901Seattle, WA 98144-2712 · (206) 548-3114 · Fax (206) 762-6355

Phone(206) 633-3350

Fax(206) 633-3113

Sole ProprietorNo

Enumeration DateNovember 8, 2006

Last NPPES UpdateJanuary 22, 2016

✔ NPI 1104996131 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in WA · DE00009739

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

1629 N 45TH ST, Seattle, WA 98103

Open in Google Maps ↗

Other Identifiers 1

Medicaid5046412WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Susan Willis Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$97.43 typical visit price

range $63.67 – $189.37

Typical copayment $24.35 (range $15.91 – $47.34)

Most-billed visit code 99203

Established Patient

$78.74 typical visit price

range $21.12 – $155.00

Typical copayment $19.68 (range $5.28 – $38.75)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Leave this field empty

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DEBRA CANNON LM

Midwife, Lay