MEDICARE: DR. KEVIN NAFICY MSD, DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	0006222	WA

General Provider Information

NPI Number	:	1033202866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN NAFICY MSD, DMD

Provider Business Mailing Address
First Line	:	15700 BEL RED RD
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98008-2231
Country	:	US
Telephone Number	:	425-881-8180
Fax Number	:

Provider Business Practice Location Address
First Line	:	15700 BEL RED RD
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98008-2231
Country	:	US
Telephone Number	:	425-881-8180
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	07/08/2007

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