Evergreen Pediatric Dentistry is a Pediatric Dental Clinic in Kirkland, Washington. It is located at 12910 Totem Lake Blvd Ne Ste 103, Kirkland, WA and its contact number is 425-814-3196. The authorized person for Evergreen Pediatric Dentistry is Dr. Susan S Kim
who is President of the clinic and their contact number is 425-814-3196. The primary license number for Evergreen Pediatric Dentistry is 9731 (Pediatric Dentistry) in Washington. Evergreen Pediatric Dentistry Clinic provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Complete Clinic Profile:
Evergreen Pediatric Dentistry Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Evergreen Pediatric Dentistry
Specialization:
Pediatric Dentistry
Clinic Address:
12910 Totem Lake Blvd Ne Ste 103, Kirkland, Washington, 98034
Phone:
425-814-3196
Fax:
425-825-9646
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Dr. Susan S Kim
Position:
President
Contact Number:
425-814-3196
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Evergreen Pediatric Dentistry clinic are as mentioned below.
NPI Number:
1265495196
NPI Enumeration Date:
11 Apr, 2006
NPI Last Update On:
17 Jul, 2018
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Evergreen Pediatric Dentistry are as mentioned below.
Specialization
License Number
State
Status
Pediatric Dentistry
9731
Washington
Primary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
5048368
Medicaid
Washington
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Evergreen Pediatric Dentistry 12910 Totem Lake Blvd Ne Ste 103, Kirkland, Washington
Zip:
98034-2901
Phone Number:
425-814-3196
Fax Number:
425-825-9646
Patients can reach Evergreen Pediatric Dentistry at 12910 Totem Lake Blvd Ne Ste 103, Kirkland, Washington or can call to book an appointment on 425-814-3196. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.