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Active NPI 1104996131 Individual Practitioner Female Practitioner

Dr. Susan Willis , DDS

Dentist - General Practice • Seattle, WA

Professional Overview & Biography Verified Profile Summary

Dr. Susan Willis, DDS is a registered healthcare professional specializing in Dentist - General Practice in Seattle, WA. Practice services are available at 1629 N 45TH ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1629 N 45th St

Seattle, WA 981036701

Telephone 2066333350
Fax 2066333113
Associated Practice Facility / Clinic
🏢 Neighborcare Health Facility NPI 1285664227

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Seattle, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 20.3 Yrs
State Avg: 21.3 Yrs
Regional Practice Density
459 Specialists

Practicing in Seattle, 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 DE00009739

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
5046412 (WA)

Practice Associates & Co-Workers

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

40 Associated Practitioners
Debra Cannon , LM

Midwife, Lay

NPI 1043320260
Tiffany Courtnage , MSW

Counselor - Mental Health

NPI 1063659381

Master of Social Work

NPI 1114037140

Licensed Independent Clinical Social Worker

Dr. Carol Cordy , MD

Family Medicine

NPI 1164532461

Doctor of Medicine (M.D.)

Dionne Kee

Counselor

NPI 1194045062
Susan Jackson , PA-C

Physician Assistant

NPI 1205914314

Physician Assistant (Certified)

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active January 22, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location January 22, 2016

Registered at 1629 N 45TH ST, SEATTLE, WA 981036701 (Tel: 2066333350)

📍
Updated Business Mailing Address January 22, 2016

Registered at 1200 12TH AVE S, SUITE 901, SEATTLE, WA 981442712 (Tel: 2065483114)

👤
Provider Name / Credentials Updated January 22, 2016

Recorded as SUSAN WILLIS, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 22, 2016

Dentist (License #DE00009739 in WA)

🟢
Initial NPI Registration & Enumeration November 08, 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: 1104996131
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 08, 2006
Last Update: January 22, 2016
Sole Proprietor: No

Mailing Address

1200 12th Ave S, Suite 901

Seattle, WA 981442712

Phone: 2065483114

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.