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EDWARD CLARK STURDIVANT DDS
NPI 1639456395
Dentist in Port Townsend, WA

Active since November 09, 2011Opted out of Medicare · through Feb 27, 2027
1119 LAWRENCE STREET, PORT TOWNSEND, WA 98368(360) 385-5121 Get Directions Write a Review

NPPES record last updated: November 9, 2011. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Edward Clark Sturdivant Dds NPPES

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

EDWARD CLARK STURDIVANT DDS (NPI 1639456395) is an individual dentist in Port Townsend, Washington, licensed in Washington (DE00004262) and active in the NPI registry since November 2011. He has opted out of Medicare through February 27, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1639456395
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameEDWARD CLARK STURDIVANTCredential: DDS
Location Address1119 LAWRENCE STREETPort Townsend, WA 98368-2224
Mailing Address1119 Lawrence StreetPort Townsend, WA 98368-2224 · (360) 385-5121 · Fax (360) 379-9534
Phone(360) 385-5121
Sole ProprietorNo
Enumeration DateNovember 9, 2011
✔ NPI 1639456395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in WA · DE00004262
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
1119 LAWRENCE STREET, Port Townsend, WA 98368
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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

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Opted out of Medicare

Edward Clark Sturdivant 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 27, 2017 through February 27, 2027.

Opt-Out Effective DateFebruary 27, 2017
Opt-Out In Effect ThroughFebruary 27, 2027Opt-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 98368 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
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$71.29 typical visit price
range $18.56 – $141.11
Typical copayment $17.82 (range $4.64 – $35.27)
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.

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 Edward Sturdivant's NPI number?

The NPI number for Edward Sturdivant is 1639456395. It was assigned to this individual provider in the NPPES registry on November 9, 2011.

Where is Edward Sturdivant located?

Edward Sturdivant practices at 1119 Lawrence Street, Port Townsend, WA 98368. The listed phone number is (360) 385-5121.

What is Edward Sturdivant's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Edward Sturdivant enrolled in Medicare?

No. Edward Sturdivant has opted out of Medicare through February 27, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Edward Sturdivant accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Florida Combined Life and 2 other insurers list Edward Sturdivant as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Edward Sturdivant was last updated on November 9, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.