MEDICARE: MICHAEL A MACINNES DDS, 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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1760330302
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL A MACINNES DDS, PLLC

Provider Business Mailing Address
First Line	:	336 228TH AVE NE STE 200
Second Line	:
City	:	SAMMAMISH
State	:	WA
Zip	:	98074-7290
Country	:	US
Telephone Number	:	425-391-8830
Fax Number	:	425-391-8857

Provider Business Practice Location Address
First Line	:	336 228TH AVE NE STE 200
Second Line	:
City	:	SAMMAMISH
State	:	WA
Zip	:	98074-7290
Country	:	US
Telephone Number	:	425-391-8830
Fax Number	:	425-391-8857

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MICHAEL A. MACINNES
Credential	:	DDS
Telephone Number	:	425-391-8830

Provider Enumeration Date	:	03/19/2026
Last Update Date	:	03/19/2026

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