DR. ADAM C. FETTIG DMD
NPI 1417047549
Dentist - Oral and Maxillofacial Pathology in Kirkland, WA

Active since October 12, 2006PECOS Enrolled
12330 120TH AVE NE, KIRKLAND, WA 98034(425) 821-7979(425) 821-0500 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Adam C. Fettig Dmd NPPES

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

DR. ADAM C. FETTIG DMD (NPI 1417047549) is an individual oral and maxillofacial pathology provider in Kirkland, Washington, licensed in Washington (8743) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417047549
Entity TypeIndividualMale
Primary Taxonomy1223P0106X
Provider Legal NameDR. ADAM C. FETTIGCredential: DMD
Location Address12330 120TH AVE NEKirkland, WA 98034-6926
Mailing Address12330 120th Ave NeKirkland, WA 98034-6926 · (425) 821-7979 · Fax (425) 821-0500
Fax(425) 821-0500
Sole ProprietorNo
Enumeration DateOctober 12, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1417047549 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Oral and Maxillofacial PathologyDental Providers
Taxonomy Code1223P0106X
License Licensed in WA · 8743
Definition

The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations.

12330 120TH AVE NE, Kirkland, WA 98034

Other Identifiers 1

Medicare UPINU44162WA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Dr. Adam C. Fettig Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 7, 2017 through November 7, 2025.

Opt-Out Effective DateNovember 7, 2017
Opt-Out In Effect ThroughNovember 7, 2025Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98034 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.

Other Providers at the Same Location NPPES 4

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

Dentist (Oral and Maxillofacial Surgery)
12330 120TH AVE NE
KIRKLAND, WA 98034
Dentist (Oral and Maxillofacial Pathology)
12330 120TH AVE NE
KIRKLAND, WA 98034
Dentist (Oral and Maxillofacial Pathology)
12330 120TH AVE NE
KIRKLAND, WA 98034
Dentist (Oral and Maxillofacial Surgery)
12330 120TH AVE NE
KIRKLAND, WA 98034

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1417047549, enumerated as an "individual" on October 12, 2006.

The provider is located at 12330 120TH AVE NE KIRKLAND, WA 98034 and the phone number is (425) 821-7979.

Dentist with taxonomy code 1223P0106X and a focus in Oral and Maxillofacial Pathology.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.