MEDICARE: VALERIY BELIY DMD, PLLC

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	DE 00008313	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649589813
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALERIY BELIY DMD, PLLC

Provider Business Mailing Address
First Line	:	3005 ALDERWOOD MALL PKWY
Second Line	:	STE 200
City	:	LYNNWOOD
State	:	WA
Zip	:	98036-6920
Country	:	US
Telephone Number	:	425-673-8919
Fax Number	:	425-673-5674

Provider Business Practice Location Address
First Line	:	3005 ALDERWOOD MALL PKWY
Second Line	:	STE 200
City	:	LYNNWOOD
State	:	WA
Zip	:	98036-6920
Country	:	US
Telephone Number	:	425-673-8919
Fax Number	:	425-673-5674

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. VALERIY BELIY
Credential	:	DMD
Telephone Number	:	425-673-8919

Provider Enumeration Date	:	10/05/2010
Last Update Date	:	10/05/2010

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