WASHINGTON DENTAL CORPORATION PC (NPI# 1205249810) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205249810 |
| Entity Type | Organization |
| Organization Name | WASHINGTON DENTAL CORPORATION PC |
| Other Organization Name | SOUTHCENTER MODERN DENTISTRY |
| Practice Address |
17420 Southcenter Pkwy Tukwila WA 98188-3701 |
| Mailing Address |
17000 Red Hill Avenue Irvine CA 92614 |
| Practice Telephone | 2533955555 |
| Practice Fax Number | 2533955560 |
| Mailing Telephone | 7148458890 |
| Mailing Fax Number | 9494741495 |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2014-06-11 |
| Authorized Official Name | DR. BRIAN S BIENSTOCK (OWNER) |
| Authorized Official Telephone | 2533955555 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Southcenter Modern Dentistry | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811490550 | Washington Dental Corporation PC | Dentist | 907 Frontier Circle E, Suite 110, Lake Stevens, WA 98258 | 2018-03-08 |
| 1114324795 | Washington Dental Corporation PC | Dentist | 16810 Meridian E Ste J107, Puyallup, WA 98375-9604 | 2014-11-26 |
| 1376945287 | Washington Dental Corporation PC | Dentist | 918 Se 164th Ave, Suite 200, Vancouver, WA 98683-9603 | 2014-09-23 |
| 1669874145 | Washington Dental Corporation PC | Dentist | 1001 Avenue D, Suite 100, Snohomish, WA 98290-2018 | 2014-09-16 |
| Street Address |
17420 SOUTHCENTER PKWY |
| City | TUKWILA |
| State | WA |
| Zip Code | 98188-3701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033761911 | Isabel Lo | Dentist | 17420 Southcenter Pkwy, Tukwila, WA 98188-3701 | 2019-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194342774 | Yemisirach Fikru Tufa | Registered Nurse | 3039 S 154th St, Aptb304, Seatac, WA 98188 | 2020-06-30 |
| 1841756608 | Silvia Ruby Campos | Behavior Technician | 651 Stander Blvd., Suite 112, Tukwila, WA 98188 | 2019-02-18 |
| 1720562036 | Alissa Hayes | Counselor | 631 Strander Bvd. Ste A., Tukwila, WA 98188 | 2018-09-21 |
| 1457859035 | Bashayer S Albadr | Student in an Organized Health Care Education/Training Program | 6100 South Center Blvd. 3rd Floor, Tukwila, WA 98188 | 2018-01-29 |
| 1356855522 | Miguel Angel Banos | Massage Therapist | 3000 Ne 4th St., Renton, WA 98188 | 2017-11-27 |
| 1801312061 | Emma Sinclair Jennings | Counselor | 651 Strander Blvd. Suite 105, Tukwila, WA 98188 | 2017-08-19 |
| 1518417526 | Jamila Fyrouz Iraqui | Counselor | 15142 65th Ave S, Apt. 312, Tukwila, WASHINGTON 98188 | 2016-10-13 |
| 1487026076 | Catholic Community Services of Western Washington | Clinic/Center | 631 Strander Blvd Ste A, Tukwila, WA 98188 | 2015-10-22 |
| 1659773174 | Thanh Thi-hong Nguyen | Physician Assistant | 3739 S 191st Pl, Seatac, WA 98188 | 2014-09-16 |
| 1053725101 | Affinity Home Care Services Inc | In Home Supportive Care | 601 Strander Blvd, Tukwila, WA 98188 | 2014-06-17 |
| Find all providers in zip 98188 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760080469 | Tanveer Singh Buttar | Dentist | 13955 57th Ave S, Tukwila, WA 98168 | 2020-10-14 |
| 1790099091 | David Ryan Dean | Dentist | 411 Strander Blvd Ste 204, Tukwila, WA 98188-2924 | 2010-07-29 |
| 1881805778 | Gursharan Singh Dhaliwal | Dentist | 13955 Interurban Ave S, Tukwila, WA 98168-4721 | 2007-05-24 |
| 1083829600 | Samuel S. Minagawa | Dentist | 664 Strander Blvd, Tukwila, WA 98188-2923 | 2007-05-14 |
| 1114146669 | Doreen Margaret Roseto | Dentist | 505 Strander Blvd, Tukwila, WA 98188-2920 | 2007-04-24 |
| 1194866111 | James Hollis Phillips | Dentist | 16218 42nd Ave S, Tukwila, WA 98188-3013 | 2007-02-11 |
| 1932270576 | Steve H Nguyen | Dentist | 15668 W Valley Hwy, Tukwila, WA 98188-5534 | 2006-11-13 |
| 1639248446 | William B Thompson | Dentist | 6840 Fort Dent Way Ste 130, Tukwila, WA 98188-2555 | 2006-11-07 |
| 1932282118 | Patricia Gallaher Benca | Dentist | 200 Andover Park E Ste 4, Tukwila, WA 98188-2938 | 2006-10-23 |
| 1982799839 | Sukhminder Singh Buttar | Dentist | 16600 W Valley Hwy, Tukwila, WA 98188-5503 | 2006-10-04 |
| Find all providers in TUKWILA | ||||
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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.