DR. PHAT T LY DMD
NPI 1720125966
Dentist - General Practice in Ridgefield, WA

Q: What is Phat Ly's NPI number?

The NPI number for Phat Ly is 1720125966. It was assigned to this individual provider in the NPPES registry on January 30, 2007.

Q: What is Phat Ly'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 Phat Ly was last updated on December 9, 2021. 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.

Active since January 30, 2007PECOS Enrolled

8507 S 5TH ST # A-101, RIDGEFIELD, WA 98642(360) 887-2310(360) 887-2309 Get Directions Write a Review

NPPES record last updated: December 9, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Dr. Phat T Ly Dmd NPPES

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

DR. PHAT T LY DMD (NPI 1720125966) is an individual general practice provider in Ridgefield, Washington, licensed in Washington (DE00010063) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1720125966

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. PHAT T LYCredential: DMD

Location Address8507 S 5TH ST # A-101Ridgefield, WA 98642-3421

Mailing Address8507 S 5th St # A-101Ridgefield, WA 98642-3421 · (360) 887-2310 · Fax (360) 887-2309

Phone(360) 887-2310

Fax(360) 887-2309

Sole ProprietorNo

Enumeration DateJanuary 30, 2007

Last NPPES UpdateDecember 9, 2021

NPPES CertifiedDecember 9, 2021

✔ NPI 1720125966 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 · DE00010063

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.

8507 S 5TH ST # A-101, Ridgefield, WA 98642

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Other Identifiers 1

Medicaid5047634WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, BridgeSpan Health Company, HRI Dental & Vision 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)

Dr. Phat T Ly Dmd 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 98642 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 Phat Ly's NPI number?

The NPI number for Phat Ly is 1720125966. It was assigned to this individual provider in the NPPES registry on January 30, 2007.

Where is Phat Ly located?

Phat Ly practices at 8507 S 5th St # A-101, Ridgefield, WA 98642. The listed phone number is (360) 887-2310.

What is Phat Ly's specialty?

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

Is Phat Ly enrolled in Medicare?

Yes. Phat Ly is registered in the Medicare PECOS enrollment system.

What insurance does Phat Ly accept?

Health plans from BEST Life, BridgeSpan Health Company, HRI Dental & Vision, Humana and Paramount and 2 other insurers list Phat Ly 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 Phat Ly was last updated on December 9, 2021. 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.