Healthcare Provider Details

I. General information

NPI: 1114037108
Provider Name (Legal Business Name): BELLEVUE SPECIALIZED DENTAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15700 BEL RED RD
BELLEVUE WA
98008-2231
US

IV. Provider business mailing address

15700 BEL RED RD
BELLEVUE WA
98008-2231
US

V. Phone/Fax

Practice location:
  • Phone: 425-881-8448
  • Fax: 425-881-0355
Mailing address:
  • Phone: 425-881-8448
  • Fax: 425-881-0355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License NumberDE00008824
License Number StateWA

VIII. Authorized Official

Name: DR. DAVID ARONOWITZ
Title or Position: OWNER
Credential: DDS, MSD
Phone: 425-881-8448