MILL CREEK IMPLANTS & PERIODONTICS (NPI# 1134677792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134677792 |
| Entity Type | Organization |
| Organization Name | MILL CREEK IMPLANTS & PERIODONTICS |
| Practice Address |
15130 Main St Ste 210 Mill Creek WA 98012-7370 |
| Practice Telephone | 4253545704 |
| Mailing Telephone | 4253545704 |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2016-09-13 |
| Authorized Official Name | LAURA OCTAVIA REAMES (OFFICE MANAGER) |
| Authorized Official Telephone | 4253545704 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
DE60455178 | WA | Dental Providers |
| Street Address |
15130 MAIN ST STE 210 |
| City | MILL CREEK |
| State | WA |
| Zip Code | 98012-7370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811502032 | Malia Van-frances Chase | Behavioral Analyst | 18311 Bothel-everett Hwy, Suite 260, Bothell, Wa, WA 98012 | 2020-09-14 |
| 1154951804 | Thea E Byrne | Physical Therapist | 6030 Bothell Everett Hwy, #140, Mill Creek, WA 98012 | 2020-01-22 |
| 1861975526 | Jenifer Rae Denormandie | Pharmacist | 14529 North Creek Drive Apt B210, Mill Creek, WA 98012 | 2018-09-10 |
| 1780161760 | Azadeh Fariba | Naturopath | 15411 40th Dr Se, Bothell, WA 98012 | 2018-07-23 |
| 1720572902 | Rickey Lee Mcgregor | Counselor | 16300 Mill Creek Blvd, Suite 204, Mill Creek, WA 98012 | 2018-06-20 |
| 1306349865 | Rudi Lauren Romaine | Behavioral Analyst | 18311 Bothell-everett Hwy, Suite 260, Bothell, WA 98012 | 2018-03-12 |
| 1164961025 | Wickler Behavioral Consulting | Behavioral Analyst | 632 182nd Street Se, Bothell, WA 98012 | 2017-02-13 |
| 1588026413 | Nathan Earl Crawford | Massage Therapist | 18930 Bothell Everett Hwy, D302, Bothell, WA 98012 | 2016-03-21 |
| 1144618083 | Jocelyn Enabulele | Counselor | 19105 Waxen Road, Bothell, WA 98012 | 2014-12-30 |
| 1124426846 | Teeth R Us | Dentist | 1908 201 Pl Se Suite #201, Bothell, WA 98012 | 2014-12-11 |
| Find all providers in zip 98012 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225653397 | Rika Takada | Dentist | B403 Health Sciences Building, Seattle, WA 98195-0001 | 2020-06-14 |
| 1467074757 | Amit Srikant Gharpure | Dentist | 1959 Ne Pacific Street Health Science Center Room B-403, Seattle, WA 98195-0001 | 2020-05-10 |
| 1922632843 | Jessica Hsu | Dentist | 625 4th Ave Ste 201, Kirkland, WA 98033-9028 | 2020-02-29 |
| 1992338891 | Ehsan Zahedi | Dentist | 18009 Highway 99 Ste F, Lynnwood, WA 98037-4499 | 2020-02-19 |
| 1780142729 | Shoko Sato | Dentist | 2505 S 320th St Ste 330, Federal Way, WA 98003-5461 | 2019-03-08 |
| 1942738497 | Yu Lwo | Dentist | 1740 Nw Maple St Ste 110, Issaquah, WA 98027-8000 | 2017-05-30 |
| 1164890026 | Shih-chung Liao | Dentist | 720 Olive Way Ste 810, Seattle, WA 98101-1836 | 2015-09-09 |
| 1225445539 | Implant & Periodontic Specialists | Dentist | 1418 112th Ave Ne Suite 100, Bellevue, WA 98004 | 2014-07-18 |
| 1093147068 | Etheridge Family Dentistry | Dentist | 3130 E Madison St Ste 103, Seattle, WA 98112-4221 | 2013-08-01 |
| 1639416183 | Jessica R Swoboda | Dentist | 10050 Ne 10th St # Stc, Bellevue, WA 98004-4121 | 2013-01-03 |
| Find all providers with the same taxonomy | ||||
| City | MILL CREEK |
| Zip Code | 98012 |
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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.