MEDICARE: DR. ARTEM CHUVASHOV DDS

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	122300000X	Dentist	DE61085709	WA

General Provider Information

NPI Number	:	1275148199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARTEM CHUVASHOV DDS

Provider Business Mailing Address
First Line	:	240 NW GILMAN BLVD STE 7
Second Line	:
City	:	ISSAQUAH
State	:	WA
Zip	:	98027-2418
Country	:	US
Telephone Number	:	425-463-7067
Fax Number	:

Provider Business Practice Location Address
First Line	:	240 NW GILMAN BLVD STE 7
Second Line	:
City	:	ISSAQUAH
State	:	WA
Zip	:	98027-2418
Country	:	US
Telephone Number	:	425-463-7067
Fax Number	:

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

Provider Enumeration Date	:	09/09/2020
Last Update Date	:	09/09/2020

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