BYRONSMIZUHA DMD,MSD, PS (NPI# 1003269473) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003269473 |
| Entity Type | Organization |
| Organization Name | BYRONSMIZUHA DMD,MSD, PS |
| Practice Address |
19320 40th Ave W Ste B Lynnwood WA 98036-4602 |
| Practice Telephone | 4257713000 |
| Practice Fax Number | 4257711319 |
| Mailing Telephone | 4257713000 |
| Mailing Fax Number | 4257711319 |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2016-07-20 |
| Authorized Official Name | DR. BYRON S. MIZUHA (PERIODONTIST) |
| Authorized Official Telephone | 4257713000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 125K00000X | Advanced Practice Dental Therapist | 4650 | WA | Dental Providers |
| Street Address |
19320 40TH AVE W STE B |
| City | LYNNWOOD |
| State | WA |
| Zip Code | 98036-4602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342630 | Zachary Perry | Behavior Technician | 4100 Veterans Way, Unit 100, Lynnwood, WA 98036 | 2020-10-08 |
| 1942832795 | Alexis Michelle Solomon-winne | Behavior Technician | 4100 Veterans Way Unit 100 Lynnwood, Wa 98036 United S, Lynnwood, WA 98036 | 2020-02-10 |
| 1881239028 | Endc Pllc | Psychologist | 19217 36th Ave W. Suite 219, Lynnwood, WA 98036 | 2019-11-12 |
| 1225507866 | Kyung Suk Seo | Massage Therapist | 18904 Hwy 99, Ste. K, Lynnwood, WA 98036 | 2018-11-13 |
| 1790270197 | Kabal Sriviboon | Behavior Technician | 20818 44th Ave W Suite 270, Lynnwood, WA 98036 | 2018-06-27 |
| 1992206148 | Kendal Ilyse Borison | Behavioral Analyst | 4100 194th Se, Suite 100, Lynnwood, WA 98036 | 2018-02-23 |
| 1205352515 | Doug Brant | Registered Nurse | 19931 Cypress Way, Lynnwood, WA 98036 | 2017-08-17 |
| 1588184980 | Evergreen Recovery Centers-lynnwood Detox | Substance Abuse Rehabilitation Facility | 20508 56th Ave W, Lynnwood, WA 98036 | 2017-06-27 |
| 1699213439 | Patrick J. Pacyga | Dentist | 19620 Wa-99, Suite 106, Lynnwood, WA 98036 | 2017-02-01 |
| 1134676646 | Fiona Green | Occupational Therapy Assistant | 21503 8th Place W, A, Lynnwood, WA 98036 | 2016-09-01 |
| Find all providers in zip 98036 | ||||
| Taxonomy Code | 125K00000X |
| Grouping | Dental Providers |
| Classification | Advanced Practice Dental Therapist |
| An Advanced Practice Dental Therapist is: (1) A dental therapist who has completed additional training beyond basic dental therapy education and provides dental services in accordance with state advanced practice dental therapist laws or statutes; or (2) A dental hygienist with a graduate degree in advanced dental therapy prepared for independent and interdependent decision making and direct accountability for clinical judgment across the dental health care continuum. The individual has been authorized by the relevant state board or a tribal entity to provide services under the remote supervision of a dentist. The functions of the advanced practice dental therapist vary based on the needs of the dentist, the educational preparation of the advanced practice dental therapist and state dental practice acts and regulations. |
| Notes: Source: Summarized from Minnesota Statute 150A.106. [7/1/2012: new] |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.