MR. CHARLES FREDRICK EBSWORTH D.D.S. NPI 1023071149

NPI Information

  • NPI: 1023071149
  • Provider Name: MR. CHARLES FREDRICK EBSWORTH, D.D.S.
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Individual
  • Address: 17191 BOTHELL WAY NE
    SUITE 201
    LAKE FOREST PARK, WA
    ZIP 98155
  • Phone: (206) 362-0152

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NPI Details

MR. Charles Fredrick Ebsworth, D.D.S. is a general practice dentist in Lake Forest Park, WA. The provider is 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. MR. Charles Fredrick Ebsworth, D.D.S. NPI is 1023071149. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

17191 BOTHELL WAY NE
SUITE 201
LAKE FOREST PARK, WA
ZIP 98155-534
Phone: (206) 362-0152
Fax: (206) 365-3441

The enumeration date for this NPI number is 4/10/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice4073WASHINGTONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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