KAYLA NICOLE RUSSELL BONHAM DDS
NPI 1508342015
Dentist - General Practice in Seattle, WA
About Kayla Nicole Russell Bonham Dds NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KAYLA NICOLE RUSSELL BONHAM DDS (NPI 1508342015) is an individual general practice provider in Seattle, Washington, licensed in Washington (DE60865965) and active in the NPI registry since July 2018. She has opted out of Medicare through February 2, 2028.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Kayla Nicole Russell Bonham Dds 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 February 2, 2022 through February 2, 2028.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SEATTLE, WA 98105
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kayla Russell Bonham's NPI number?
The NPI number for Kayla Russell Bonham is 1508342015. It was assigned to this individual provider in the NPPES registry on July 17, 2018.
Where is Kayla Russell Bonham located?
Kayla Russell Bonham practices at 3819 NE 45th St, Seattle, WA 98105. The listed phone number is (206) 524-6116.
What is Kayla Russell Bonham's specialty?
The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.
Is Kayla Russell Bonham enrolled in Medicare?
No. Kayla Russell Bonham has opted out of Medicare through February 2, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
When was this NPI record last updated?
The NPPES record for Kayla Russell Bonham was last updated on March 31, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kayla Nicole Russell Bonham, DDS · NPI 1508342015
General Practice provider in Seattle, Washington. Individual provider, active in the CMS NPPES registry since July 17, 2018.
## Identity
- **NPI:** 1508342015 (Entity type: Individual)
- **Enumerated:** July 17, 2018
- **Primary specialty:** Dentist - General Practice · taxonomy 1223G0001X
- **State license:** DE60865965 (Washington)
- **Sole proprietor:** No
## Practice location
- **Address:** 3819 NE 45TH ST, Seattle, WA 98105-5144
- **Phone:** (206) 524-6116
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through February 2, 2028); services are provided under private contract
## Record status
- **NPPES last updated:** March 31, 2022
---
Source: [NPI Profile](https://npiprofile.com/npi/1508342015) · Data from the CMS NPPES public registry.