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Active NPI 1104849900 Individual Practitioner Male Practitioner

Dr. Kam Derakshani , DDS

Dentist - General Practice • Bellevue, WA

Professional Overview & Biography Verified Profile Summary

Dr. Kam Derakshani, DDS is a registered healthcare professional specializing in Dentist - General Practice in Bellevue, WA. Practice services are available at 1551 116TH AVE. NE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1551 116th Ave. Ne
#b-1

Bellevue, WA 98004

Telephone 4253731605
Associated Practice Facility / Clinic
🏢 Byungjun Park, Dds, Pllc Facility NPI 1588900419

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Bellevue, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.3 Yrs
Regional Practice Density
148 Specialists

Practicing in Bellevue, WA (3345 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License WA DE7712

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1265810063

Doctor of Dental Surgery

Dr. Byungjun Park , DDS

Dentist - General Practice

NPI 1306091418

Doctor of Dental Surgery

NPI 1851055156

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active April 15, 2009

NPI status registered as active in NPPES database

📍
Updated Practice Location April 15, 2009

Registered at 1551 116TH AVE. NE, #B-1, BELLEVUE, WA 98004 (Tel: 4253731605)

📍
Updated Business Mailing Address April 15, 2009

Registered at 1551 116TH AVE NE STE B1, BELLEVUE, WA 980043814 (Tel: 4253731605)

👤
Provider Name / Credentials Updated April 15, 2009

Recorded as KAM DERAKSHANI, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 15, 2009

Dentist (License #DE7712 in WA)

🟢
Initial NPI Registration & Enumeration July 25, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104849900
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 25, 2006
Last Update: April 15, 2009
Sole Proprietor: No

Mailing Address

1551 116th Ave Ne Ste B1

Bellevue, WA 980043814

Phone: 4253731605

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.