Healthcare Provider Details

I. General information

NPI: 1013357979
Provider Name (Legal Business Name): KAITLIN JEAN NESTE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KAITLIN JEAN POPPE DDS

II. Dates (important events)

Enumeration Date: 06/25/2013
Last Update Date: 04/25/2023
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 TORMEY LN NE STE 198
BAINBRIDGE ISLAND WA
98110-1990
US

IV. Provider business mailing address

3637 NW BYRON ST
SILVERDALE WA
98383-9127
US

V. Phone/Fax

Practice location:
  • Phone: 206-899-1737
  • Fax: 206-629-9416
Mailing address:
  • Phone: 360-692-9560
  • Fax: 360-692-1729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number60379179
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number60379179
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: