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FEDERAL WAY MODERN DENTISTRY
NPI 1689140758
Dentist in Federal Way, WA

Active since October 16, 2018CLIA 50D2339497 · Waiver
164 SW CAMPUS DR STE 101, FEDERAL WAY, WA 98023(253) 432-8942(253) 432-8945 Get Directions Write a Review

NPPES record last updated: December 26, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 11, 2019, Oct 16, 2018 (2 updates tracked since 2018).

About Federal Way Modern Dentistry NPPES

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

FEDERAL WAY MODERN DENTISTRY (NPI 1689140758) is a healthcare organization registered as a dentist in Federal Way, Washington and active in the NPI registry since October 2018. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Jessica Ahn, Owner, as its authorized official.

NPPES Registry Identity

NPI1689140758
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameWASHINGTON DENTAL CORPORATION, PC
Location Address164 SW CAMPUS DR STE 101Federal Way, WA 98023-7926
Mailing AddressPo Box 920050Dallas, TX 75392-5626 · (714) 845-8890 · Fax (303) 952-0892
Phone(253) 432-8942
Fax(253) 432-8945
Organization SubpartNo
Authorized OfficialJessica AhnOwner · (253) 432-8942
Enumeration DateOctober 16, 2018
Last NPPES UpdateDecember 26, 20232 updates tracked since enumeration
NPPES CertifiedDecember 26, 2023
✔ NPI 1689140758 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
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.
164 SW CAMPUS DR STE 101, Federal Way, WA 98023
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Other Names 1

Doing Business AsFederal Way Modern Dentistry

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D2339497

Federal Way Modern Dentistry · Federal Way, WA
Active · expires Apr 4, 2028
CLIA Number50D2339497
Laboratory TypeOther Practitioner
Certificate Effective DateMarch 3, 2026
Certificate Expiration DateApril 4, 2028
Laboratory DirectorIshita Masand
Laboratory Phone(253) 432-8942
Laboratory LocationFederal Way Modern Dentistry164 SW Campus Dr. Ste 101, Federal Way, WA 98023
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

MINH QUANG PHAN
Dentist (General Practice)
164 SW CAMPUS DR STE 101
FEDERAL WAY, WA 98023
King County (253) 432-8942
SEEMALAXMI CHAWAN AEGD
Dentist (General Practice)
164 SW CAMPUS DR STE 101
FEDERAL WAY, WA 98023
King County (235) 432-8942
DR. ROBERT MAU DDS
Dentist (General Practice)
164 SW CAMPUS DR STE 101
FEDERAL WAY, WA 98023
King County (253) 432-8942

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 Washington Dental Corporation, PC's NPI number?

The NPI number for Washington Dental Corporation, PC is 1689140758. It was assigned to this organization in the NPPES registry on October 16, 2018. The provider is doing business as Federal Way Modern Dentistry.

Where is Washington Dental Corporation, PC located?

Washington Dental Corporation, PC is located at 164 SW Campus Dr Ste 101, Federal Way, WA 98023. The listed phone number is (253) 432-8942.

What is Washington Dental Corporation, PC's specialty?

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

Does Washington Dental Corporation, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2339497) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Washington Dental Corporation, PC accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Washington Dental Corporation, PC 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 Washington Dental Corporation, PC was last updated on December 26, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.