IVY DENTAL FOR KIDS NPI 1639381874

NPI Information

NPI: 1639381874
Provider Name: IVY DENTAL FOR KIDS
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
18623 HWY 99
SUITE 210
LYNNWOOD, WA
ZIP 98037
Phone: (425) 275-9977
Get Directions

IVY DENTAL FOR KIDS is a general practice dentist in Lynnwood, 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. IVY DENTAL FOR KIDS NPI is 1639381874. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

18623 HWY 99
SUITE 210
LYNNWOOD, WA
ZIP 98037-552
Phone: (425) 275-9977
Fax: (425) 275-9979

The provider's authorized official is Yoon Lee .
The authorized official title is Dentist and has the following contact phone number (425) 275-9977.

The enumeration date for this NPI number is 5/3/2007 and was last updated on 8/22/2020.

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
1	1223G0001X	Dentist	General Practice	9491	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5041611	MEDICAID	WASHINGTON

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: 5/5/2024

NPI Synchronization or Removal

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